June is National Migraine and Headache Awareness Month, and if you're one of the millions of people who experiences frequent headaches, you know that a bad headache can be annoying, but a migraine can be debilitating. A cure for migraines hasn’t been found, but preventative medicines can help reduce them, as can diet, exercise and getting into a consistent sleep routine. “By definition, chronic migraines are 15 or more headache days per month with only eight having migraine features such as nausea, vomiting and light and/or sound sensitivity,” said Blount Memorial Physicians Group neurologist Dr. Christine Hagen, a United Council for Neurologic Subspecialties-certified headache specialist. In order to tailor the best treatment to your specific diagnosis, a neurologist will ask for an extensive history, including any headache treatments you may have tried in the past.
Traditionally, most migraine treatments have been medicines designed for other things, such as blood pressure, depression or epilepsy. “In the last five years, breakthroughs in migraine treatments have significantly changed. In 2018, the first ever preventatives designed specifically for migraines came out on the market. Prior to that, we only had acute treatments designed for migraine,” Hagen explained. CGRP (calcitonin gene-related peptide) is a protein released around the brain that causes inflammation and transmits pain signals into the brain. The CGRP protein has been determined to be what causes the pain most patients feel during a migraine attack. The CGRP self-injector pen is the first preventative medicine specifically developed to treat migraines by blocking these CGRP proteins.
There are hardly any side effects to CGRP treatments and, as in most cases with injectables, it’s limited to site reaction, such as redness. In addition, CGRP can be used in combination with other migraine treatments to enhance effectiveness and increase the number of headache-free days. “When it comes to pain, we’re looking for quality of life. We’re looking to decrease the number of headaches, but it may not be perfect. We may not get to zero headaches, but we can decrease the number of them and the severity of them,” Hagen stated.
Once treatment starts, Hagen requests patients keep a headache calendar so they can chart progress. “The response to the medication depends on the individual and his or her biology. These do tend to work better with time, so we follow up periodically to see how things are going. Some patients report these CGRP preventative medications have been life-changing and have greatly improved their quality of life,” Hagen said.
Even patients who have not achieved results with previous migraine treatments seem to have success with CGRP treatments. Botox remains another preventative option. “If you have tried migraine treatments in the past and were not satisfied with the results, trying one of the newer ones developed in the last few years or trying a combination of treatment options could show benefits,” Hagen explained.
For more information about treatments for chronic headaches and migraines, or to make an appointment with Dr. Hagen, call 865-238-6471.