The U.S. Centers for Disease Control and Prevention (CDC) report that migraines, or severe headaches, affect more than 15 percent of U.S. adults. That adds up to more than 39 million Americans afflicted with migraine attacks lasting up to 72 hours. These debilitating episodes cause severe pain in the head, face, and neck, often sending affected individuals into darkened rooms to avoid triggers. Fortunately, initiatives to develop new migraine drugs are on the horizon – with potentially life-changing effects for migraine sufferers.
What Causes Migraines?
As reported by Science News, researchers still don’t know exactly what causes migraine headaches. At one point, researchers believed that blood vessel dilation was to blame; however, that theory has fallen out of favor. The current theory, according to Science News, is that triggers like hormonal changes and stress activate nerve cells in the brain. Theoretically, the nerve cells then get overexcited and stimulate the trigeminal nerve, the largest of the cranial nerves. This nerve triggers the release of calcitonin gene-related peptide, or CGRP, in the brain, causing transmission of pain signals. The release of pain signals then triggers more CGRP, which then triggers the dilation of blood vessels. The reaction also releases toxic chemicals into the brain, causing excruciating pain.
Effects of Existing Migraine Drugs
Even though migraines affect such a large portion of the population, sufferers may not find relief in available treatments. Interestingly, many drugs prescribed for migraines were first developed for other conditions. For example, doctors often prescribe beta blockers for migraines, which were first developed to treat hypertension. Science News explains that this treatment is based on findings that high-blood pressure patients who also had migraines reported fewer migraines after taking beta blockers. Unfortunately, popular treatments like beta blockers are ineffective for 40 to 50 percent of chronic migraine patients, according to a 2017 analysis of insurance claims data. The drugs also come with long lists of side effects, often causing weight gain, nausea, brain fog, drowsiness, and even speech disturbance, to name a few. Ultimately, many migraine sufferers are desperate for a better, more effective solution for chronic headaches.
New Migraine Drugs: CGRP Inhibitors
While the exact mechanism behind migraines remains unclear, scientists do know that the headaches involve the activation of the trigeminal nerve. As mentioned above, CGRP, which is produced by the trigeminal nerve, is known to contribute to severe migraines. With this in mind, scientists are taking a new approach: blocking the action of CGRP. Specifically, researchers are working to block this action via lab-generated monoclonal antibodies, which are manufactured proteins that can bind to substances in the body. These antibodies can either block CGRP’s receptor or physically grab hold of CGRP. That intervention can, in a manner of speaking, stop migraines in their tracks by pausing the “chain reaction” that causes extreme pain.
Effects of CGRP Treatment
The Science News article demonstrates the highly promising effects of CGRP-focused migraine treatment. For example, one patient received a monthly injection of erenumab (sold as Aimovig®), a drug approved in 2018 that utilizes several monoclonal antibodies. The antibodies inhibit CGRP action and have greatly enhanced the patient’s quality of life. “I’m not stuck in a darkened room,” the patient told Science News. “I have a life again. You can’t put a price on that.”
Like any drug, CGRP inhibitors may not work for everyone. They do, however, represent a new frontier of drug development. Developments like these could pave the way for a new reality for migraine sufferers – one with a dramatically better quality of life. Speak to your doctor if you are interested in additional information about these relatively new treatment options.
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