The cruel intersection of a global pandemic and an agitating, still-contested election has not been kind to migraine sufferers. With our stress levels climbing higher than ever, cases of these debilitating headaches have risen accordingly, says Emad Estemalik, MD, who leads the Cleveland Clinic’s headache division. “Heightened stress, triggered by the amount of time we spend navigating through news and social media, translates to more screen time and eyestrain that can certainly increase headache frequency,” Estemalik confirms. If someone gets three to five headache days per month, he says, pandemic-related stress can bump that to 10-15 days.
And the blows just keep coming. Of the one in seven adults that suffer from migraines globally, women are disproportionately affected, and are three times more likely to be impacted by them than men. More than just throbbing temple pain, the often-debilitating neurological disease with a broad range of symptoms—including nausea, dizziness, sensitivity to noise, light, and scents, and visual disturbances—can last for hours, or days, and currently, there is no cure. But there is some good news, says Christopher Gottschalk, MD, Chief of General Neurology at Yale University School of Medicine and one of the country’s leading migraine specialists. According to Gottschalk, we are in the midst of “an extraordinary period” of revolutionary ideas, devices, and medications for migraine sufferers. “For 25 years, what I’ve had to say to people is, ‘Here, try this. Hope it helps, good luck. It may cause side effects. If you keep getting headaches, well, I really can’t do much about it. Now,” he says, “we can give somebody a shot and say, ‘In a month, you will probably be better. And in two months you’ll probably be even better than that.” Gottschalk laughs. “It still shocks me that I can say all those words in the same sentence.” Here, a breakdown of the new ways to find relief from pervasive headaches, politically-induced or otherwise.
CGRP Inhibitors
Until recently, many drugs used by doctors for migraines were developed for other conditions, such as epilepsy. But in the past few years, the FDA has approved several new classes of targeted, effective drugs developed specifically for migraines. Even better, they have markedly fewer side effects than commonly used tryptamine-based drugs, also known as triptans, which have been used since the early 90s to relieve headaches but often come with major side effects such as nausea, insomnia or hair loss. CGRP-inhibitors, medications that block calcitonin gene-related peptide—a protein released by the brain during migraine attacks (and “a very ugly, cumbersome name,” says Gottschalk)— are among the most promising. Three of these prescription-only drugs—Aimovig, Ajovy, and Emgality— are taken monthly with an EpiPen-like shot; a fourth, Vyepti, is administered via IV by a doctor every three months. “These drugs produce great results, in much less time, with almost no side effects,” Gottschalk confirms. Nurtec and Ubrelvy, which are gepants—another new class of FDA-approved medication, that also targets CGRP molecules—are formulated to turn off migraines in progress rather than prevent them. “They don’t have quite as much bang for the buck as, say, an injection of [the commonly-used triptan] Sumatriptan,” says Gottschalk. “But they’re well tolerated and can do a great job.”
Serotonin Receptor Blockers
Yet another medication developed specifically for migraines is a class of drugs called ditans, the first of which is a pill called Reyvow that was approved by the FDA last October. It works by activating serotonin receptors in the brain that block pain signals. Its website claims “you could be 100 percent pain free in two hours;” but it also warns against operating heavy machinery for at least eight hours after taking the drug, so if you happen to drive a car, it may not be right for you.
Psychedelic Wellness
Gottschalk and his colleagues at Yale are also researching psilocybin, the active ingredient in psychedelic mushrooms, which was just decriminalized in Oregon and has been indicated as a potential remedy for migraines, among many other ailments. “Our pilot studies are looking very promising,” he says. “You can take a sub-hallucinogenic dose of psilocybin, and stop cluster headaches for weeks and migraines also.”
Wearable Devices
The Cefaly Dual, a once-prescription-only device that is the size of an eyeshadow compact and worn on the forehead, was just approved by the F.D.A. as an over-the-counter treatment. It sends tiny electrical impulses to stimulate the trigeminal nerve, a cranial nerve that is a prime source of headache pain. Meanwhile, my sister, who has endured migraines for years, is one of the many fans of the ridiculous-looking but effective Magic Gel Headache and Migraine Relief Cap. Simply store the cap in the freezer to firm up its inch-thick layer of gel, then slip it on and wear until your migraine is manageable. Two other new F.D.A.-cleared devices are controlled by smartphone: the Nerivio is a band worn on the upper arm, which sends electrical signals that disrupt pain pathways during a migraine episode, while an app called JUVA Health provides clinician-developed biofeedback exercises, which studies show can reduce migraine severity by calming the nervous system.
Light Therapy
While sensitivity to light can be a trigger for some migraine sufferers, a recent University of Arizona study found that exposure to green light one to two hours a day, can reduce the number of headache days per month by an average of 60 percent. It sounds counterintuitive, but isolated green light from devices such as the Allay lamp, which was developed by Harvard Medical School migraine researchers, has been shown to reduce photophobia, or light sensitivity, by generating certain electrical signals in the eye and brain.
The post A Host of New Treatments Promise Relief From That Election-Induced Headache appeared first on Honk Magazine.
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