The Tide is Turning in Migraine Treatment
Migraines affect twelve percent of the population, most of them women. One in four women will get migraines in her lifetime. But until recently, there hasn’t been much development of medication that can treat or prevent them.
Migraines are more severe than regular headaches, and the symptoms can last as long as three days. The symptoms can include sensitivity to light and noise, as well as nausea and vomiting. Once the migraine is gone, the person can be left with exhaustion.
Medications that can help treat migraines once they start include over-the-counter aspirin and ibuprofen, and antiemetics — medications that treat nausea and vomiting. Caffeine can help as well.
Prescription medications such as sumatriptan can help get rid of a migraine once it comes on, but people may still have to face debilitating pain, nausea, vomiting, and sensitivity to light and sound for hours. And some people can’t take sumatriptan, depending on their medical history.
A new medication, called Reyvow (lasmiditan), was recently approved to treat acute migraines. It can be taken by mouth, and can get rid of a migraine in two hours.
But when someone has frequent migraines (15 or more a month), it’s best to talk to a doctor and consider starting a medication that prevents them. At that point, migraines often affect people’s work and personal lives. Cutting out migraines at the source is the ideal.
Until recently, prevention sometimes consisted of taking an antidepressant, like amitryptyline. This is because migraines are thought to be affected by serotonin (which is how many antidepressants and Reyvow work).
Topiramate, a medication used for seizures, can be taken daily to prevent migraines, but it doesn’t work for everyone.
Some blood pressure medications help, but they can have side effects. And these treatments work for some people, but not everybody.
One current theory is that migraines are caused by the calcitonin gene-related peptide (CGRP) sending pain signals. Three new medications — erenumaub, galcanezumab, and fremanezumab — work by blocking CGRP, and have been approved in the U.S. as preventative migraine treatment.
These medications are given as an injection and can work for weeks or months, eliminating the need for a daily pill. They are by prescription only, so you’ll need to talk to a doctor to get them.
Problems in the visual cortex of the brain have also been implicated in migraines, which could explain why migraineurs can experience sensitivity to light, as well as visual blurring or flickering (called auras). This avenue can also lead to new treatments.
The newer medications are expensive, but as time goes on, the cost should decrease. Research on migraines is improving, and migraineurs no longer have to suffer in silence.