Understanding new treatment options for migraines

Each year, about 4 million emergency department visits and another 4.3 million doctor office visits are due to migraines, which affect about 16% of adults in the United States.¹

But thanks to new, effective treatments, migraine sufferers can now enjoy an improved quality of life.

There’s more to migraines than just a headache

Migraine episodes are caused by a neurological disease that causes changes in brain activity. These changes often occur in four stages, although people may experience some stages but not others.

1. Prodrome: This can begin hours or even days before the headache starts. Symptoms include mood swings, food cravings, and neck stiffness.
2. Aura: Before the headache starts, some people experience sensory disturbances. These can include blurred vision or growing blind spots, numbness in the arms, dizziness or vertigo, or slurred or confused speech.
3. Headache: While headache pain during a migraine is often severe, other people experience a mild headache or no headache at all. In this stage, light, sounds, smells, and even moving around can make the pain worse. Keep in mind there are many different types of headaches, so you’ll want to see a doctor trained in treating headaches (neurologist) to get a proper diagnosis.
4. Postdromal: This is after the pain has stopped, but migraine sufferers are usually extremely tired, confused, and generally not feeling well during this stage.

Migraines usually last from 4 to 72 hours. For some people, migraines can happen 15 or more days each month.²

New treatments for migraine show promise

People who suffer from migraines have more of a certain protein — calcitonin gene-related peptide (CGRP) — in their blood. CGRP can cause inflammation in the central nervous system, which in turn leads to an array of debilitating migraine symptoms.

New medications target CGRP. These medications, called CGRP inhibitors, work in one of two ways. Some of them block the places in the brain where CGRP attaches. Others bind to CGRP and keep it from causing pain. They can be given by injection, pill, or by intravenous (IV) infusion.

CGRP inhibitors are more effective than traditional migraine medications, which can sometimes result in headaches from medication overuse for people who need to use them often. Also, CGRP inhibitors seem to work faster. Overall, CGRP inhibitors cut the number of headache days by at least half for 47% to 62% of people studied.³

CGRP inhibitors: What are the risks?

Most people experience fewer side effects from CGRP inhibitors than from traditional migraine medications. Side effects of CGRP inhibitors can include:

• Nausea and vomiting
• Back pain
• Dry mouth
• Upper respiratory and urinary tract infections
• Liver toxicity
• Joint stiffness
• A sensation of tingling or “pins and needles”
• Fatigue
• Visual problems
• Headache

CGRP inhibitors are considered very safe, even for pregnant women. Although CGRP is important for heart health, studies have found that CGRP inhibitors are safe for migraine sufferers who also have heart disease. Since CGRP inhibitors are newer medications, information about long-term safety is not yet available.

Support is just a phone call away

If you suffer from migraines, you may have questions about your current prescriptions or whether CGRP inhibitors could help reduce your symptoms. At Express Scripts® Pharmacy, you have 24/7 access to pharmacists who are specially trained in migraines and other neurological disorders — so we can support you anytime, day or night. Just give us a call.

1 National Library of Medicine: The prevalence and impact of migraine and severe headache in the United States: Updated age, sex, and socioeconomic-specific estimates from government health surveys (January 2021): https://pubmed.ncbi.nlm.nih.gov/33349955/.
2 National Library of Medicine: CGRP Inhibitors for Migraine (April 1, 2020): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413335/.
3 National Library of Medicine: Therapeutic novelties in migraine: new drugs, new hope? (April 17, 2019): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734360/.