Standard diabetes and weight reduction drugs like Ozempic and Mounjaro present potential for treating a slew of different well being points, from osteoarthritis to binge consuming. Now, new analysis means that these medication—which belong to a category often called GLP-1s—may additionally assist relieve migraines.
Particularly, folks with weight problems and continual migraine skilled considerably fewer complications after a three-month stint taking liraglutide, a GLP-1 at present used to deal with sort 2 diabetes, researchers reported June 17 within the journal Headache.
Migraine impacts roughly 14% of the worldwide inhabitants, making it a number one reason behind incapacity worldwide. The brand new examine was small, with simply 31 folks, and consultants warning that extra analysis is required. Nonetheless, the findings trace at a promising new pathway for migraine aid.
“Regardless of many developments in migraine remedy in recent times, there are nonetheless many sufferers that suffer from intractable migraines who could profit from rising remedy,” mentioned Samantha Flanagan, DO, an weight problems drugs doctor with Temple Well being.
To know how GLP-1s affect migraine, the researchers recruited 26 girls and 5 males with weight problems (a physique mass index over 30) and continual migraine (complications on no less than 15 days monthly).
Members took a each day shot containing 1.2 milligrams of liraglutide over 12 weeks. Every day, they stuffed out a diary detailing the depth and frequency of their migraine signs. Roughly 38% of the members skilled delicate gastrointestinal unintended effects like nausea and constipation.
On the finish of the examine, members skilled a mean of 11 fewer headache days a month. Most sufferers seen enhancements inside the first two weeks. The members additionally recorded substantial boosts in high quality of life through a instrument referred to as the Migraine Incapacity Evaluation Take a look at.
These enhancements occurred regardless of the group’s BMI barely altering—on common, it dropped from 34.0 to 33.9. Due to this, the researchers concluded that GLP-1s could successfully cut back migraine signs, even within the absence of serious weight reduction.
Regardless of the promising outcomes, the examine had a number of limitations. First, it was observational and lacked a management group, making it unclear whether or not the migraine enhancements had been straight attributable to liraglutide or influenced by different components, Richard Baron, MD, a neurologist with Stanford Medication, advised Well being.
There was additionally no blinding—each the members and the researchers had been conscious that they had been taking the medicine, which might introduce bias.
That mentioned, the examine, whereas small, opens up the door for future analysis, Flanagan mentioned.
Trying ahead, Baron mentioned he’d wish to see randomized, double-blinded, placebo-controlled trials—thought of the gold normal of scientific testing—look at the affect of GLP-1 medication on migraine frequency and depth.
Although it’s nonetheless too quickly to know if GLP-1s really can alleviate migraine signs, researchers have some theories about how they may achieve this.
One thought is that they might decrease intracranial strain, or strain that builds up from the presence of fluids inside the cranium. Even barely elevated strain could sensitize the trigeminovascular system, a community of neurons within the mind intently concerned in migraine. This could set off the discharge of headache-causing compounds referred to as calcitonin gene-related peptides, which decrease an individual’s threshold for ache and complications.
Earlier analysis helps this idea: GLP-1s have been discovered to scale back cerebrospinal fluid secretion and intracranial strain. Moreover, a number of small research counsel that GLP-1s could enhance migraine signs in folks with idiopathic intracranial hypertension, a situation that causes chronically excessive intracranial strain, mentioned Deena E. Kuruvilla, MD, FAHS, a neurologist and medical director of the Mind Well being Institute. (Notably, the brand new examine excluded folks suspected of getting this situation.)
One other chance, based on Baron, is that GLP-1s could counteract the consequences of weight problems which are thought to contribute to migraine assaults, comparable to irritation and fluctuations in hormones like leptin and orexin.
“On condition that the GLP-1 agonists appear to scale back irritation related to weight problems, have an effect on obesity-related hormonal signaling, and reduce intracranial strain—even earlier than weight reduction is achieved—it is extremely cheap to count on these drugs to be useful in decreasing migraine assault severity and frequency in sufferers with migraine and weight problems,” Baron mentioned.
Whereas there are a number of migraine therapies accessible—together with oral drugs, injections, way of life adjustments, and neuromodulatory units—the situation is notoriously tough to deal with.
Based on the American Headache Society, insufficient preventative medicine and unidentified triggers are two of the commonest causes migraine therapies fail. As well as, many individuals proceed to expertise refractory, or intractable, complications which are resistant to straightforward therapies.
GLP-1 medication will not be but accredited by the Meals and Drug Administration for migraine prevention, and treating migraine with them isn’t but the usual of care, Kuruvilla mentioned.
However Kuruvilla advised Well being that she’s had a number of sufferers with refractory complications “who had exhausted a number of conventional migraine preventives with out success” take GLP-1 s and expertise vital migraine aid. “I at all times stress that migraine enchancment is a possible secondary profit, not a assured final result,” she mentioned.
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