Dry Powder Inhaler In The Treatment Of Migraine: A Review

Abstract

Inhalers deliver medication directly to the lungs, avoiding the need to swallow tablets or capsules. It is beneficial for those with dysphagia (1) Migraine is a common and debilitating neurological disorder characterized by recurrent, severe headaches often accompanied by nausea, vomiting, and hypersensitivity to light and sound. According to the World Health Organization (WHO), migraines are one of the leading causes of disability worldwide, affecting approximately 12% of the global population, with a higher prevalence in women. The complex pathophysiology of migraine involves multiple factors, including vascular, neuronal, and inflammatory processes, which result in the characteristic symptoms of intense headache and sensory disturbances. Despite the substantial burden of migraine on patients' quality of life, effective treatment options remain limited, and many individuals fail to achieve adequate symptom relief with traditional therapies(2).

The treatment landscape for migraines has evolved significantly over the past few decades, with a range of pharmacological options now available to alleviate symptoms. These treatments generally include acute medications aimed at terminating an ongoing migraine attack and preventive medicines designed to reduce the frequency and severity of future attacks(3). Triptans, such as sumatriptan, remain the gold standard for acute migraine treatment due to their ability to target serotonin receptors and constrict dilated blood vessels, a key contributor to the migraine process. However, while triptans are highly effective for many patients, they are not suitable for all individuals due to contraindications, side effects(4), and the need for rapid intervention during the onset of symptoms.

One of the newer innovations in migraine therapy is the development of dry powder inhalers (DPIs) for the delivery of migraine medications(4). DPIs offer several advantages over traditional oral and injectable formulations, particularly in terms of their rapid onset of action and ease of use. The concept of inhaling migraine medication in powder form, such as dihydroergotamine (DHE) (5), has gained significant attention due to its potential to provide faster relief compared to other routes of administration. Inhalation therapy also bypasses the gastrointestinal system, avoiding issues such as delayed absorption and gastrointestinal side effects that are commonly associated with oral medications.