- An anti-migraine drug appears to be effective in preventing ‘rebound’ headaches in a new study.
- The medication is effective enough that people who take it have less need for additional pain medication that can cause headaches.
- The drug, atogepant, relaxes the blood vessel where the migraine attack begins, preventing it from becoming too large and irritating the meninges below the skull, causing the pounding pain associated with migraine.
A drug used to prevent migraines may also help reduce so-called migraine headaches, according to a new analysis of data from a randomized, double-blind, placebo-controlled migraine trial. placebo.
When the drug, atogepant, is taken daily, the pain associated with migraine can be reduced,
The study was led by neurologist Peter J. Goadsby, MBBS, MD, PhD of King’s College London in the United Kingdom, and a member of the American Academy of Neurology.
Its findings appear in the journal Neurology.
There were 755 participants in the trial, each of whom had chronic migraine. Each had at least 15 headache days per month, at least eight of which qualified as migraine.
Among the entire group, 66% used painkillers, which often happens with people trying to get rid of their headache.
They used mild analgesics – such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or acetaminophen – for at least 15 days each month. Some took triptans or ergot alkaloids for at least 10 days. Others took a combination of both for at least 10 days a month.
The trial began with a 4-week evaluation/baseline period.
At the beginning of the trial, the participants had 18 to 19 days per month, and they took pain medication for 15 to 16 days.
Individuals were then assigned to take 30 milligrams (mg) of atogepant twice a day, 60 mg of atogepant once a day, or a placebo for 12 weeks. During this time, they were monitored for the frequency of their use of painkillers.
Participants who took atogepant took painkillers for a few days during the trial. In addition, a high proportion of participants taking atogepant had a 50% or greater reduction in headaches per month.
Overall, said Goadsby, “[m]”igraine is an inherited brain disease whose attacks are caused by changes in the brain and changes in the external environment.”
“We know the physiology, but we don’t know what causes migraines because there are different triggers for different people,” Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center, said. Santa Monica, CA, who was not involved. in education, be told Medical News Today.
He said: “For example, more people who have red wine compared to white wine get it. Most people with cheese get it. Caffeine both causes and treats headaches. So we still don’t know exactly what causes headaches. ”
Modern medical treatments for migraine attacks fall into two camps: prevention and rescue. Atogepant is a preventive drug, although it is closely related to two other drugs – ubrogepant and rimegepant – which are rescue drugs and a combination of prevention / rescue, respectively.
“Atogepant is a migraine preventative,” Goadsby said. “By taking it every day, the patient has fewer migraines and a much reduced need for strong treatments such as painkillers. In fact, it stops the attack before it starts.”
The drug is “relaxing [involved] the blood vessel, which makes it narrower and not wider, and when it’s not wider, it feels better,” Segil explained.
Goadsby also explains headaches again and why they happen. He told us that:
“Rebound headache occurs when the medicine taken to relieve the attack stops and the headache returns. Say you have a migraine that will last for 2 days. If you take the medicine on the first day that lasts for 24 hours, the headache will come back (it comes back) the next day, and you should take another treatment.”
“The biggest problem with migraines is that people take too much medicine, so we can get what is called ‘medication overload’ or headache. The simplest example is when someone has pain and takes Motrin, Advil, or Alleve. [or some other] NSAID every day,” Segil explained.
Goadsby also warned that some pain medications, such as NSAIDs, which are taken frequently, can cause stomach ulcers and other attacks on the digestive system.
“Taking pain medication can increase the number of migraine days that a patient has so-called medication overload, so taking less pain medication can prevent that,” he said.
According to Segil, overuse of pain medication may not give migraine attacks a chance to go away.
Migraine is a headache that is usually characterized by a throbbing pain, sometimes covering half of the head.
It may be accompanied by an uncomfortable reaction to bright lights and loud noises – photophobia or phonophobia, respectively – with or without blurred vision or visual acuity, which is a difficult symptom to explain where the vision is becoming prismatic.
Generally speaking, when people get migraines, there is a blood vessel between the brain and the skull in your meninges, and when the blood vessel becomes very large, it expands. It pulls the meninges [which is] brain stem. That often causes excruciating pain,” Segil explained.
“After that, there is an irritation of the cerebral cortex, and an electrical wave called cortical spreading depression, and it’s usually a radiating pain,” he explained.
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