Fig. 6From: Cilostazol induced migraine does not respond to sumatriptan in a double blind trialThe 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 vesselBack to article page