Migraine treatments

Hutan · Apr 4, 2022

Mij said: ↑

A new medication, approved by the F.D.A. just over a year earlier, called ubrogepant or Ubrelvy, had been effective for many. The drug blocks a protein that promotes the inflammation in the brain that is thought to initiate the process that produces migraines. When taken at the very start of the symptoms, it can stop the episode in its tracks.
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That's interesting Mij. Lots of us get migraines, has anyone tried this drug?

lunarainbows · Apr 4, 2022

Hutan said: ↑

That's interesting Mij. Lots of us get migraines, has anyone tried this drug?
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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

Mij · Apr 16, 2022

Hutan said: ↑

That's interesting Mij. Lots of us get migraines, has anyone tried this drug?
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This drug is being advertised by Serena Williams on U.S tv commercials.

Hutan · Feb 20, 2023

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.

Sly Saint · Sep 4, 2023

merged

If you're one of the millions of people suffering with migraine, potential good news is in the pipeline. A new drug, which has been shown to reduce attacks by half, could soon be available.

The pill, which is called Atogepant, appeared to slash the volume of participant's attacks from eight to four a month in study trials.

Now licensed by the Medicines and Health Products Regulatory Agency (MHRA), the Daily Mail reports that experts predict it will soon be available for widespread prescription, pending approval from the National Institute For Health and Care Excellence (NICE).

Atogepant is understood to work by blocking the impact of the calcitonin gene-related peptide, (CGRP) which is the protein that triggers migraine attacks.

Professor Peter Goadsby of Kings’ College Hospital discovered the existence of CGRP in the eighties. He has said that this new drug could be be ‘life-changing’ for migraine sufferers.

‘While the migraines themselves are incredibly painful, the worst part of the condition is the unpredictability. Something as simple as going out for a coffee with friends becomes difficult,’ he said.

Currently, more than 5.6 million people in the UK have episodic migraines. A migraine attack is a recurring, throbbing pain which tends to last from a few hours to days. Other symptoms of a migraine involve nausea, vomiting and light or sound sensitivity.

Fingers crossed that once Atogepant is approved, patients will see an improvement on accessing treatment via the NHS.
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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)

Ash · Sep 4, 2023

Dare I hope?

Hutan · Sep 4, 2023

I found this recent paper useful in understanding these recent medicines for migraine:
Calcitonin Gene-Related Peptide Receptor, 2023, Rashid and Manghi

CGRP receptor antagonists and monoclonal antibodies against CGRP and its receptor are medications used in the management and treatment of migraine, which is the sixth-highest cause worldwide of years lost due to disability as per the Global Burden of Disease Study (2013). This activity describes the indications, actions and, contraindications for these drugs as a valuable agent in the prophylaxis and acute management of migraine and cluster headaches. This activity will highlight the mechanism of action, monitoring, adverse events, relevant interactions, and other key elements in the clinical setting as relates to the essential points needed by members of an interprofessional team managing the care of patients with migraines.
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Calcitonin gene-related peptide is a 37-amino acid neuropeptide and a potent vasodilator produced by neurons in both the central and peripheral nervous systems.[1] The receptor for this neuro-peptide is a complex heterodimer containing a class B G-protein coupled receptor called CLR (calcitonin receptor-like receptor).

In the central nervous system, researchers observed that a raised level of blood and salivary levels of CGRP occur in patients with headache disorders such as migraines and cluster headaches and neuralgias such as trigeminal neuralgia, chronic paroxysmal hemicranias, and even rhinosinusitis. Levels are elevated during a migraine attack and between migraine attacks in patients with chronic migraines. Also, CGRP from exogenous infusions was shown to trigger migraine attacks.[2] Later studies showed that CGRP released in the trigeminal neurons was associated with the release of vasoactive neuropeptides and vasodilation of the cerebral vasculature, thus playing a role in the pathogenesis of migraine.
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CGRP was also shown to have cardio-protective action in pathological conditions, as demonstrated in rodent models of different cardiovascular diseases. Studies in humans have also demonstrated that CGRP decreases afterload and increases inotropy, cardioprotective in heart failure. However, there are no drugs developed to date that take advantage of this effect on the cardiovascular system.[4]

Similarly, newer studies find that CGRP is also involved in several other physiological/pathological phenomenon such as peripheral nerve regeneration, Alzheimer's disease, vascular tone of mesenteric arteries, and pregnancy. However, no drugs have been developed which take advantage of these effects of CGRP.
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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.

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