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Fig. 6 | The Journal of Headache and Pain

Fig. 6

From: Cilostazol induced migraine does not respond to sumatriptan in a double blind trial

Fig. 6

The intracellular mechanisms in a smooth muscle cell after sumatriptan, cilostazol and calcitonin gene related peptide (CGRP) administration. Sumatriptan acts on 5HT1B/D receptors coupled to Gi receptors. This leads to an inhibition of adenylate cyclase and consequently a decrease in cAMP. Cilostazol inhibits PDE3 and thus cause intracellular cAMP accumulation. cAMP activates PKA which leads to a number of intracellular changes and in the end a relaxation and dilatation of the vessel

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