Migraine headaches affect more than 30 million Americans and can be more than just a nuisance. For many, migraines are a disabling neurological disorder that can be highly disruptive to a normal lifestyle, forcing people to miss work school, social events, and sometimes forcing them into dark, quiet rooms for hours, if not days.
To date, treatment for migraine headaches involved their prevention (avoiding some common food triggers or stress, for example), and treatment with painkillers, botox, and anti-inflammatory medications. For many, these treatments have been insufficient, and patients’ lifestyles have continued to suffer dramatically.
New Migraine Medication!
I am happy to tell you that two new medications have been recently approved for migraines that attack these vascular headaches from a much more focused direction. Rather than provide patients with less generalized painkilling or anti-inflammatory medications, these new drugs act on “CGRP”, that is “calcitonin gene-related peptide” (or the receptors). This class of medications falls under the “monoclonal antibody therapies” — a different approach from current therapies.
Calcitonin gene-related peptide is a protein that is released around the brain. When CGRP is released, it causes intense inflammation in the coverings of the brain (the meninges). For most migraine patients, CGRP causes the pain of a migraine attack. In fact, if you give CGRP intravenously to a person prone to developing migraines, most of them will get a migraine within four hours. That’s the basis of all the new treatments.
Once it was determined that CGRP caused a migraine, it became clear that if we could do something to stop CGRP, we could probably stop a migraine. Four companies decided to create antibodies against CGRP and against the receptor to which CGRP binds.
AimovigTM (erenumab) is a monoclonal antibody against the CGRP receptor. The additional new medications are monoclonal antibodies against the CGRP protein and include galcanezumab (EmgalityTM) and fremanezumab-vfrm (AJOVYTM).
What Makes These Medications Different?
CGRP inhibitors are the first drugs specifically approved for migraine prevention in more than 50 years, truly making this a golden era of headache medicine. People living with a migraine can now access three different therapies designed specifically for their disease, with more options and new possibilities for treatment on the horizon.
Great news for migraine sufferers, I like to think more broadly about those of us who deal with inflammatory vascular problems that may or may not include migraine headaches. Could drugs such as these be helpful? We must all keep our thinking caps on!
One other mention I have concerning migraine sufferers who get some relief with Botox injections in the neck. We see many people who are diagnosed with migraines with light sensitivity, sound sensitivity, and nausea — with extreme neck tightness and pain. Although Botox can help some, if a headache is actually due to abnormal intracranial pressure, the underlying problem persists after treatment. The neck feels better, but everything else remains!
It can be tough to pick apart the difference between a true migraine headache and a headache that mimics a migraine! But to provide the best care for the patient, it is worth the effort!
My kids and I were three of these, after all.
Dr. Diana Driscoll is now working full time at POTS Care. A recovered POTS/EDS patient, and mom of children who have now also recovered, she has been instrumental in finding the underlying medical conditions responsible for this and other potentially disabling “invisible” illnesses.
More information into my journey with POTS, chronic neck pain and headaches, EDS, and all it entailed can be found in “The Driscoll Theory”.
POTS Care is the only clinic treating POTS by locating and treating the underlying medical cause of POTS — not just the symptoms.
We are located in Colleyville, Texas — near Dallas/Fort Worth International Airport.
Call us today at 1-866-DIZZY-05 (1-866-349-9905)
American Migraine Foundation (2018, September 15). FDA Approves Second Anti-CGRP Treatment for Migraine. Retrieved from https://americanmigrainefoundation.org/understanding-migraine/fda-approves-second-anti-cgrp-treatment-for-migraine
Office of the Commissioner. (2018, May 17). Press Announcements – FDA approves novel preventive treatment for migraine. Retrieved November 8, 2018, from https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm608120.htm
Prado, B. M., & Russo, A. F. (2006). CGRP receptor antagonists: A new frontier of anti-migraine medications. Drug Discovery Today: Therapeutic Strategies, 3(4), 593-597. doi:10.1016/j.ddstr.2006.11.003