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AHS 2022 | Pharmacogenomics in medicine and migraine treatment

Yi-Chieh Chen, PharmD, Mayo Clinic, Rochester, MN, discusses the significance of pharmacogenomics in medicine and migraine treatment. Verapamil is a calcium channel blocker and, as a lipophilic substance, in theory, should have a higher concentration in the central nervous system (CNS). However, due to the P-glycoprotein (PGP) transporter, verapamil does not have a strong presence in the CNS. Thus, a PGP inhibitor could increase verapamil concentration in the CNS, demonstrating the potential to influence therapeutic responses for migraine patients. Established data using pharmacogenomic phenotypes to modulate dose adjustment for antidepressants has shown that antidepressants can also be effective as a treatment for migraine prevention in certain individuals. Dr Chen further elaborates on the CYP2D6 actional pharmacogenomic biomarker, describing the need for increasing or decreasing doses of antidepressants. Therefore, antidepressants have provided insight on implementing data on pharmacogenomic phenotypes to help predict doses for migraine preventive treatments. This interview took place during the 2022 American Headache Society (AHS) Meeting in Denver, CO.