In a new study from the Mayo Clinic, researchers found more pain-relieving options for people with migraine headaches.
They found that several drug classes showed good evidence that they ease the pain of a migraine-in-progress.
Some of those medications have only become available in the past few years, opening up new options for migraine sufferers who don’t get enough relief from old standby drugs.
In the study, the team looked at 115 clinical trials and 15 previous evidence reviews.
They found several new treatments of migraines, including the oral medications lasmiditan (Reyvow), which acts on a receptor for the hormone serotonin; and two “gepants” called ubrogepant (Ubrelvy) and rimegepant (Nurtec).
Gepants interfere with CGRP, a small protein released by the trigeminal nerve that plays a key role in generating migraine misery.
The review found strong evidence supporting long-used migraine treatments—namely, nonsteroidal anti-inflammatory drugs like ibuprofen (Advil, Motrin) and aspirin, and a class of migraine-specific drugs called triptans.
All of those medications beat placebos in reducing pain two hours into a migraine attack, and one day later.
Meanwhile, both lasmiditan and the gepants looked good when it came to reducing or erasing pain two hours into an attack, and one day later.
But for the most part, triptans remain the first choice for treating acute migraines.
Triptans work by targeting serotonin (in a different way than lasmiditan). They are often effective at dulling pain, but a downside is they constrict blood vessels.
That means people at increased risk of heart attack or stroke typically cannot use them.
For some other patients, triptans simply do not work, or the side effects—like numbness, dizziness and sleepiness—make them difficult to take. That’s where alternatives come in.
The team also found medications are not the only treatment option.
They showed that several nerve-stimulating devices outperformed “sham” devices in easing migraine pain.
The gadgets are used at home and employ electric or magnetic pulses to stimulate certain nerves involved in pain signaling.
The review also highlights a medication class that should not be used for migraine pain—opioids.
The drugs, such as OxyContin and Vicodin, carry the risks of dangerous side effects and addiction. And when it comes to migraine pain, they simply do not work, Burch said.
The bottom line, according to the team, is that the “right” migraine treatment plan varies from person to person—and effectiveness, safety and cost all matter.
If you care about migraines, please read studies about people with migraine need to take care of their eyes and findings of what migraine sufferers need to know about stroke risk.
For more information about migraine and your health, please see recent studies about this new drug may treat migraine more effectively and results showing that migraine headaches linked to dementia, but only in women.
The study is published in the Journal of the American Medical Association. One author of the study is Dr. Juliana VanderPluym.
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