If you suffer from frequent migraines, you’re no stranger to the debilitating aches and pains that accompany them. What you’re probably even more familiar with is the lack of understanding surrounding migraine prevention. While nearly 15% of the population, roughly 39 million people, suffer from migraines, scientists and doctors alike are still unsure what the exact causes of migraine headaches are.
Currently, there are a few preventative treatments available to help reduce the frequency and severity of migraine attacks. Those medications include divalproex sodium, flunarizine, topiramate, propranolol, and timolol. These medications have all been shown to reduce migraine frequency, but with varying success rates.
However, a new drug known as Atogepant has shown significant results in migraine prevention in its recent Phase 3 trials.
What is Atogepant?
A recent study published in the New England Journal of Medicine found that a drug called atogepant could significantly reduce the number of migraines you have per day. Atogepant is an orally administered drug known as a calcitonin gene-related peptide (CGRP) replicator. CGRP is a type of molecule that is thought to be involved in the cause of migraines.
The team of scientists involved with the study says that they observed increased blood levels of CGRP during migraine attacks and a positive response to CGRP therapy. Currently, CGRP-targeted therapies all involve injection and do not help with migraine prevention. However, the researchers found that orally administered atogepant not only worked as a migraine treatment but for migraine prevention as well.
How Can Atogepant Help with Migraine Prevention?
In the atogepant Phase 3 trials, the drug was tested on a group of 873 individuals. The group ranged from age 18-80, and migraine frequency ranged from 4-14 migraines per month. Participants in the study were divided up into four distinct groups: three groups received varying doses of atogepant (10mg, 30mg, and 60mg), while one group received a placebo.
The average number of migraines per month across all of the groups before the study ranged from 7.5 to 7.9. The group that received 10mg of atogepant experienced an average decrease of -3.7 migraines per month. The group that received 30mg of atogepant saw a decrease of -3.9 migraines per month. Lastly, the group that received 60mg of atogepant saw a decrease of -4.2 migraines per month. The placebo group saw a decrease of only -2.5 migraines per month. Atogepant showed significant success in migraine prevention across all groups. Researchers say it achieved a more than 50% reduction in monthly migraine days for all doses after three months.
Another significant finding from the group was the drug’s ability to reduce the amount of “acute medication” needed to treat migraines. Acute medications are used at the onset of a migraine to help with the pain. These medications can include things like aspirin, triptans, or paracetamol. All of these medications are used after migraines begin. In the 30mg and 60mg groups, atogepant “significantly reduced the amount of acute medication needed to treat migraine headaches.”
The most common side effects observed in the study were constipation and nausea, which accounted for 6.9% and 4.4% of participants respectively.
Atogepant is currently under review by the U.S. Food and Drug Administration (FDA) as a potential new method of migraine prevention. A regulatory decision is anticipated in late 2021.
What Can You Do in the Meantime to Prevent Migraines?
Migraine prevention is an extremely important tool to have for anyone who suffers from frequent attacks. Combatting your migraines can help you significantly improve both your quality of life and your mental health.
There are currently many options available to help treat and prevent future migraines. Those treatments can involve medication, therapy, or at-home treatments.
Below are some common medications and treatments available to help prevent migraines.
Migraine Prevention Medications
There are several known medications used for migraine prevention. Some of the most common include:
Anticonvulsants: Anticonvulsants’ primary use is to prevent or reduce seizures. However, studies show they also help with both migraine prevention and migraine pain. Common anticonvulsants include topiramate or valproic acid.
Beta-Blockers: Beta-blockers are drugs that relax your blood vessels. While these drugs are often used for high blood pressure, they have shown to be effective at treating migraines. Some beta-blockers include atenolol, nadolol, metoprolol, or timolol.
Botulinum Toxin (Botox): Small amounts of botox injected around your face and scalp every 3 months reduces migraine frequency. This treatment is only approved for individuals who suffer from more than 15 migraines per month.
Antidepressants: Antidepressants are another drug that may not seem likely to treat migraines, but in fact, does so quite effectively. Some antidepressants used to treat migraines include amitriptyline, nortriptyline, or duloxetine.
Therapies and Alternative Medicines for Migraine Prevention
Acupuncture: Some studies have pointed towards acupuncture as a potential method of migraine prevention. In this type of treatment, a practitioner inserts many tiny needles into several areas of your skin. One study found a reduction in migraines of nearly 59% in individuals who received acupuncture.
Supplements: Several different supplements and herbs are thought to treat headaches and help with migraine prevention. Some of the most common are vitamin B2, Feverfew, and Butterbur. Studies show that these supplements help treat migraines, with mixed results.
Cognitive Behavioral Therapy (CBT): CBT can benefit some individuals who suffer from migraines. This type of therapy teaches you how behaviors and thoughts affect how you perceive pain.
Mindfulness: Healthy mindfulness practices like meditation and yoga can be great ways to combat the stresses involved with migraines. If done regularly, meditation can help reduce the frequency of migraine attacks.
While atogepant continues its pursuit of FDA approval as a possible method of migraine prevention, you can try some of the above-mentioned treatments. Medications such as atogepant are breakthroughs in the realm of migraine prevention and treatment. Not only can it reduce the number of migraines you have, but it can significantly reduce the number of acute medications needed to treat them after they start.
Have You Heard of Atogepant for Migraine Prevention?
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