New Migraine Prevention Medication: Could This Be the Cure?

A migraine is a severe throbbing usually located on one side of the head. This condition affects over 3 million people yearly and occurs in adults and children. The symptoms can last for days or weeks and are very debilitating.

Adults between the ages of 30 and 40 are the most impacted, according to a MedAlertHelp¹ report containing migraine statistics from various credible sources. One of the most shocking statistics states that 10% of school-aged children suffer from migraines. As a result, everyone may benefit from the new migraine treatments.

New, promising therapeutic alternatives are emerging in modern medicine, providing promise for improved migraine symptom management and prevention.

Migraine sufferers typically take medicine to treat their active migraine attacks, and some also need drugs to avert future headaches. Significant progress has been made in various types of therapy, offering new migraine prevention medication in varied ways.

This is our in-depth look at the new migraine prevention medication and how they might be able to help you avoid severe headaches.

Our objective at HealthMatch is to advance clinical research so that we can deliver life-changing drugs sooner and more efficiently. We aim to make discovering and accessing clinical studies straightforward for everyone using technology. We simply provide all that information within your reach.

New therapies for acute migraine

1. Oral migraine medication

Triptans are often prescribed for quick migraine relief, but advances in migraine studies have contributed to the creation of new oral migraine drugs. These oral medications include gepants,² which target and lower CGRP. CGRP is a calcitonin gene-related peptide, a protein that causes inflammation in the brain.

Ditans, such as lasmiditan (REYVOW®), is another emerging oral drug class. Unlike gepants, lasmiditan works inside the central nervous system and mutes the headache during an intense attack. It blocks serotonin receptors on the nerve endings in the brain. Since it traverses the blood-brain barrier, it can induce dizziness and drowsiness.

Ubrelvy (ubrogepant), Qulipta (atogepant), and Nurtec (rimegepant) are the other oral drugs.

Ubrelvy is designed to treat but not prevent severe migraines, while Qulipta is intended to prevent migraine headaches. Nurtec is suitable for both the prevention and treatment of migraines. FDA approved Qulipta (atogepant) in September 2021.

The main concern with these new oral migraine prevention medications is misuse. Overuse of over-the-counter medicines or triptans can trigger more severe headaches. Many recurrent headaches that develop into chronic cases are typically caused by medication misuse.

Benefits of using these oral medications

• These drugs are a game-changer for people that suffer adverse side effects from previous migraine medications.

• Individuals in this breakthrough class of pharmaceutical migraine treatment can start on a full dose sooner than those taking traditional migraine medications.

Downsides of using oral migraine medication

• It may be a while before health insurance firms decide to cover these new drugs.

• It is recommended that you do not drive for at least eight hours after using Lasmiditan.

• There are several drug interactions to be aware of with gepant tablets.

2. Nasal migraine medication

When oral migraine medicines are ineffective, dihydroergotamine, or DHE, is an alternative. It's available in various forms, including injectable, infusion, and nasal spray. Doctors prescribe DHE nasal sprays for immediate relief.

While DHE is hardly a recent remedy, the methods for delivering it into the system are. TRUDHESATM (dihydroergotamine mesylate nasal spray) was recently approved by the FDA. This drug employs a patented nasal administration mechanism that enables the medicine to penetrate deeper into the nasal passage, improving absorption.

Some migraine sufferers who previously had issues with symptoms like vomiting now have a new treatment option.

Benefits of nasal treatment

• It has a faster delivery time for quick migraine pain relief.

• Nasal spray for migraine treatment is ideal for people that suffer from nausea that oral drugs may cause.

Downsides of nasal migraine treatment

• They may induce a dry mouth or an odd taste in the mouth.

• They may cause a runny or stuffy nose.

3. Monoclonal antibodies

Antibodies generated by humans in the labs to bind to specific proteins in the body are called monoclonal antibodies.³ As migraine preventive medicines, they bind to the calcitonin gene-related peptide (CGRP). CGRP widens blood arteries in the brain, which plays a role in pain and migraines.

One monoclonal antibody drug, Aimovig (erenumab), works by blocking the CGRP receptor site, while others work by inhibiting CGRP. Individuals, by themselves, can use the monthly injections of Aimovig (erenumab), Ajovy (fremanezumab), or Emgality (galcanezumab).

Ajovy (fremanezumab) can be injected each month or every three months, while another antibody called Vyepti (eptinezumab) is administered as a three-month IV infusion.

Benefits of monoclonal antibodies

• Since the medicine is injected directly into the bloodstream relieves almost instantaneous migraine.

• Monoclonal antibodies reduce the number of migraines per month.

Downsides of monoclonal antibodies

• There is the possibility of swelling or discomfort when the injection enters your skin.

• Aimovig (erenumab) may cause a spike in blood pressure and constipation.

• There is the possibility of adverse skin allergic reactions like hives, rashes, and swelling.

4. Trigger points and botox injections

The FDA has granted botox the green light as a potential treatment for people who suffer from severe migraines. These people typically experience migraines at least 15 days each month, and each migraine lasts for four hours or more on average.

A person receives at least 31 injections in various locations across and around the shoulders and the head during treatment with this therapy.

Most individuals note a decrease in the days they experience headache symptoms. After completing the first two treatment sessions, which are carried out every quarter, they start recording fewer migraine cases.

Because they employ the same botulinum toxin used in cosmetic botox treatments, the possible side effect responses, such as muscle weakness, could be the same. 

Benefits of botox and trigger points injections

• They help reduce migraine over a long period.

• They reduce the rate of migraines per month.

• Botox is an FDA-approved treatment.

Downsides of botox and trigger point injections

• There is the possibility of redness, swelling, and pain on the injection site.

• There is a likelihood of an allergic reaction to botox, like swollen lower legs, shortness of breath, and hives.

5. Neuromodulation devices

In addition to oral drugs, infusions, nasal sprays, and injections, neuromodulation technologies could transform how the neurons in the nerves communicate signals to the brain or alter how the brain switches on and off the pain sensation.

Neuromodulation devices are cutting-edge medical instruments that can alter the nervous system's activation level to enhance or reduce its function.

According to studies,⁴ this innovation can help lower the frequency of cluster headaches and migraine episodes. Even though most of these gadgets call for a doctor's prescription, the FDA has given its approval for CEFALY® DUAL, one of these devices to be distributed without a prescription.

Individuals have the option to use certain forms of neuromodulation for both preventative and chronic migraine therapy. Here are some types already in the market:

The single-pulse transcranial magnetic stimulator

This is a small device held by a hand that alters the electrical impulse signaling in the brain by creating a magnetic stimulation. It was first licensed to manage acute migraine accompanied by an aura and was finally certified for migraine prevention.

Transcutaneous supraorbital neurostimulator

This stimulates the supraorbital nerves with electrical impulses. The gadget is presently FDA-certified for both migraine prevention and severe migraine treatment. It may help reduce migraine recurrence.

Transcutaneous vagus nerve stimulator

This is a nonsurgical handheld device that stimulates the vagus nerve in the neck using electrical pulses. It has been licensed to alleviate recurrent cluster headache episodes and migraine symptoms. This gadget was authorized for migraine prevention in teenagers aged 12 to 17 in 2021.

Relivion

This is the latest gadget that has also been FDA-approved. It is positioned on top of the head, directly above the point where the occipital nerves, also known as the nerve endings in the scalp, meet the trigeminal system. These nerves control sensations in the face and motor function. It is believed that providing stimulation to this location will avoid future migraine episodes.

Benefits of neuromodulation devices

• People who suffer from migraine can mitigate all physical side effects associated with other migraine treatments.

• They work as both treatment and preventive therapies for migraines.

• The treatment is easily reversible.

• They are non-invasive migraine treatments that offer fast results in reducing migraine frequencies.

Downsides of neuromodulation devices

• These devices are costly.

• There is never a standard reaction to this treatment since everyone's nervous system is unique.

What new migraine prevention medication is best for you?

The new migraine preventive medication is revolutionary to help lower the frequencies of migraines in people who suffer from it, but how do you choose what is best for you?

Here are a few questions to ask yourself that may help you select the best option

Have you talked to your doctor?

The first thing you should do is talk things over with your primary care physician. They will analyze all aspects of your case, openly discuss the benefits and drawbacks of each type of therapy, and then recommend the treatment plan that will be most effective for you.

You may have one or more options available, depending on your health, lifestyle, and personal preferences. A medical professional will guide you on the most effective therapy to treat and prevent migraines while having minimal adverse effects.

What is the frequency and intensity of my migraines?

By counting the number of times they strike in a given month, you can determine the frequency of your migraine headaches. Migraine attacks can range from as little as five episodes per month to as many as 15 or more episodes within the same period for some persons.

The intensity of the migraine refers to how painful it is. Some people suffer from migraines that are not severe and allow them to perform routine duties. On the other hand, some people suffer from extremely severe migraines that render them incapable of moving.

Your specific migraine characteristics will help guide the optimal therapy. For example, people who suffer from frequent intense migraines can try neuromodulation devices, monoclonal antibodies, botox, and nasal therapy.

How often do I need the treatment?

To answer this question, you will consider how long the recommended course of treatment will last and how frequently you will need to start a new dose.  Like drugs taken orally and nasally to prevent migraines, some require regular dosing, with each day's regimen consisting of a few pills or sprints. If you stop taking medications, there is a possibility that the migraines will return.

Experts may consider treatments with monoclonal antibodies and botox intermediate types because their effects could last from a few weeks to many months. The number of times you need to use the device will be directly proportional to how well it works for neuromodulation devices.

According to scientific research, there are two different strategies to cure migraines. One way to manage migraines is to take medicine, which consists of pharmaceuticals that ease the pain and other symptoms associated with the condition.

The second approach is to take measures to ensure that the attack does not occur in the first place. Because it is preferable to avoid symptoms rather than treat them, the new migraine prevention medication focuses on the second method.

The lowdown

There are numerous new migraine prevention medication options for migraine sufferers, each with distinctive pros and cons. Explore your options carefully, keep track of possible side effects, and talk to your doctor about how you can manage or avoid migraines.