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Migraines & Headaches Health Center

Prevention: The Future of Migraine Therapy

Stopping a migraine headache before it ever begins is the new focus of treatments.
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Taking a shower hurts. Shaving hurts. Even your hair hurts when you're in the throes of a migraine headache.

Until a few decades ago, people had little more than aspirin to fight the throbbing, debilitating pain of a migraine headache. Then, in the 1980s, researchers developed strong drugs to halt migraine pain once it begins. But those drugs have serious side effects. Some people cannot take them if they are at risk for heart disease or other conditions. Also, if the drugs are not taken within the first hour of migraine headache pain, they don't help much.

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These older drugs are still prescribed. But more recently, the approach to taming this lion has made a 360-degree turn. Now, prevention is the focus. It involves disabling a migraine headache before the pain ever begins. One method is to take non-migraine drugs daily to help prevent a migraine from starting. The drugs affect brain chemicals or blood vessel inflammation that lead to migraines.

Another is to fine-tune treatment for each patient. The goal is to take fewer drugs, avoid many side effects, and have better control of the beast. For example, you become aware of your pattern of getting a migraine headache, learn what triggers it, and take certain drugs during your own window of vulnerability - that is, the brief window of time you can most benefit from a drug.

Finding Your Migraine's Window of Vulnerability

The FDA is currently reviewing a new migraine drug called Trexima, which combines the migraine drug Imitrex (sumitriptan) and naproxen sodium (a nonsteroidal anti-inflammatory drug) contained in Aleve and other over-the-counter medications. The triptan prevents blood vessels from dilating. This dilating leads to migraine pain; the anti-inflammatory drug prevents release of an inflammation-triggering enzyme, according to product developers.

Also in the pipeline: A drug that shows promise as both in preventing migraines and in stopping a migraine once one starts, says George R. Nissan, DO, director of research for the Diamond Headache Clinic in Chicago. The drug works by inhibiting a protein released during inflammation, called calcitonin gene-related peptide (CGRP). CGRP is found in high levels in migraine patients.

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