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Migraine treatments

Discussion in 'Drug and supplement treatments' started by Sasha, Nov 30, 2017.

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  1. Hutan

    Hutan Moderator Staff Member

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    That's interesting Mij. Lots of us get migraines, has anyone tried this drug?
     
    Hutan, Apr 4, 2022
    #21
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  2. lunarainbows

    lunarainbows Senior Member (Voting Rights)

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    Im waiting for this drug to come to the U.K. I’m pretty sure it’s an acute medication that works on anti CGRP pathways?

    The good news is that there are already some preventative anti CGRP injection medications available in the U.K in headache clinics. Ajovy, Aimovig etc. They cost around £300 a month privately (which is why I haven’t been able to access them even though they are the meds I need!), but are free in some NHS clinics. Getting access on the NHS also requires jumping through several hoops.

    https://www.healthline.com/health/migraine/cgrp-migraine#how-its-taken
     
    Last edited: Apr 4, 2022
    lunarainbows, Apr 4, 2022
    #22
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  3. Mij

    Mij Senior Member (Voting Rights)

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    This drug is being advertised by Serena Williams on U.S tv commercials.
     
    Mij, Apr 16, 2022
    #23
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  4. Hutan

    Hutan Moderator Staff Member

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    Bumping this thread, with two fairly recent papers reporting higher levels of CGRP in people with fibromyalgia, and the treatment inhibiting CGRP receptors. Interesting to read that account of a person whose migraine involved post-exertional symptoms up thread.
     
    Hutan, Feb 20, 2023
    #24
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  5. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    merged

    A new NHS backed wafer could help thousands of migraine sufferers (msn.com)
     
    Last edited by a moderator: Jul 23, 2024
    Sly Saint, Jun 3, 2023
    #25
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  6. Hutan

    Hutan Moderator Staff Member

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    Rimegepant for the treatment of migraine, 2022

    Abstract
    Migraine is a common form of primary headache, affecting up to 1 in every 6 Americans. The pathophysiology is an intricate interplay of genetic factors and environmental influence and is still being elucidated in ongoing studies. The trigeminovascular system is now known to have a significant role in the initiation of migraines, including the release of pain mediators such as CGRP and substance P. Traditional treatment of migraine is usually divided into acute and preventive treatment. Acute therapy includes non-specific therapy, such as NSAIDs and other analgesics, which may provide relief in mild to moderate migraines. 5-HT1 agonists may provide relief in severe migraine, but are not universally effective and carry a significant side-effect profile with frequent redosing requirement. Prophylactic therapy may reduce the occurrence of acute migraine attacks in selected patients, but does not completely eliminate it.

    More recently, CGRP antagonism has been studied and shown to be effective in both abortion and prevention of migraine. Novel medications, targeting CGRP, divide into CGRP antibodies and receptor antagonists (gepants). Rimegepant, a second-generation gepant, has shown efficacy in several clinical trials in treating acute migraine. Ongoing trials are also evaluating its role in migraine prophylaxis, and results are promising. It is also generally safer for use than existing options, does not appear to increase the chance of developing chronic migraines, and carries a very tolerable side effects profile. It is a part of a growing arsenal in migraine treatment, and may present the silver bullet for treatment of this disease.
     
    Hutan, Jun 4, 2023
    #26
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  7. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    New drug thought to cut migraine attacks by half could be available within months (msn.com)

    eta:another article with more info


    'Life-changing' tablet that tackles common illness could be available in UK by Christmas (msn.com)
     
    Last edited by a moderator: Sep 4, 2023
    Sly Saint, Sep 4, 2023
    #27
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  8. Ash

    Ash Senior Member (Voting Rights)

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    Dare I hope?
     
    Ash, Sep 4, 2023
    #28
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  9. Hutan

    Hutan Moderator Staff Member

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    I found this recent paper useful in understanding these recent medicines for migraine:
    Calcitonin Gene-Related Peptide Receptor, 2023, Rashid and Manghi
    It's interesting to think how the raised blood CGRP in people prone to migraines might also be related to orthostatic intolerance and PEM. Interesting also that it might be related to peripheral nerve regeneration, and that it can be cardio protective.

    I think there could be an interesting study there to track CGRP levels in people with ME/CFS who get migraines. It would be good to know if these medicines for migraine help with ME/CFS symptoms.
     
    Hutan, Sep 4, 2023
    #29
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  10. obeat

    obeat Senior Member (Voting Rights)

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    Merged thread
    I have suffered from migraine for 40 years and severe ME for 30 years. I am eligible for a trial of rimegepant as a prophylactic medicine and wonder if anyone else has tried it.


    Also has anyone tried botulinum toxin?
     
    Last edited by a moderator: Jul 23, 2024
    obeat, Jul 20, 2024
    #30
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  11. Sasha

    Sasha Senior Member (Voting Rights)

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    I tried botox by a doctor with a very good track record of success for it and it had zero effect. Apparently it doesn't work for some people the first time and effects only show up on the second set of injections, which should be about three months later, but I wasn't able to get those.

    I tried botox for my migraines because it was rated 8/10 in Dr Alexander Mauskop's optimistically titled book, 'The End of Migraines'. :) He was one of the first neurologists to use it for migraines, and thinks it's underutilised. You can read about it on his clinic's website here.

    FWIW, he rates rimegepant at 7/10 in his book. The edition I have is dated 2021, so I don't know if there's recent evidence on either of these treatments that would affect his ratings.
     
    Sasha, Jul 20, 2024
    #31
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  12. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    I have never tried botulinum toxin but I've always thought it sounded terrifying. Would it be used to inject migraine sufferers in the head?

    I've only seen it used (on TV) for two different problems - smoothing out wrinkles on the face and how it can cause the face to become expressionless until it wears off, and secondly it is used to inject young children who become phobic about defecating so they hold it in all the time.
     
    Arnie Pye, Jul 20, 2024
    #32
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  13. Sasha

    Sasha Senior Member (Voting Rights)

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    You might like to read the link to Dr Mauskop's work in my above post and I think it will set your mind at rest! You get injections in the scalp, mainly, loads of them. I barely felt a thing (very fine needle) and it was over very quickly. Because it's not your face getting injected (apart from your forehead a bit, IIRC), you don't end up expressionless.
     
    Sasha, Jul 21, 2024
    #33
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  14. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

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    I had my second round of botox for chronic migraine last month (given at 3 month intervals). I had to fail 3x oral preventatives and have >15 migraine days a month to qualify for it on NHS. It's not prescribed for episodic migraine and I'm unsure how effective it would be for that. I suffered with episodic migraine for 30 years before the transformation to chronic, they're related but chronic feels like a different beast to me.

    I have seen a sustained reduction in migraine days from roughly 5 days per week before botox down to 2 days per week now. The second dose hasn't appeared to have reduced that frequency further, though I am noticing a further drop in migraine severity and can now fully kick a migraine the same day with triptans.

    I get the feeling that the injectable monoclonal antibody anti-CGRP treatments (Erenumab + others) are a more effective preventative than the oral gepants. I will be trialling the mAbs in due course but also plan to try rimegepant for acute as I find triptans pretty unpleasant to take.

    Yes - most follow the PREEMPT trial and administer ~30 injections across the hairline, brow, above the ears, back of head & shoulders. Quite different to cosmetic use, I find it hard to frown now and perhaps have a few less wrinkles on my forehead but no obvious visual difference.
     
    Ryan31337, Jul 22, 2024
    #34
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  15. Sasha

    Sasha Senior Member (Voting Rights)

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    Here's a video of Dr Mauskop doing the injections for migraine in four minutes.
     
    Sasha, Jul 22, 2024
    #35
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