Quite a few studies have been coming up recently focusing on rimegepant, one of the CGRP related medications that have been getting a lot of coverage in the last 5 years.

The “gepant” medications such as rimegepant are CGRP receptor antagonists, especially known for their ability to act fast to fight a migraine attack. And recent studies seem to confirm this for rimegepant. This study from Japan, published last year, showed good results when using a typical 75mg dose. (Efficacy and safety of rimegepant for the acute treatment of migraine in Japan)

A “real world” study in Italy, also published last year, was also positive. Patients had especially good results when they took the medication during the first hour of the migraine attack. (Effectiveness and tolerability of rimegepant in the acute treatment of migraine)

Reading these studies, you’ll see again that this is no miracle drug, but it does help a lot of patients significantly, even patients who have not had a lot of success with previous medications. This study, published late last year, had similar results for patients who had not had success with triptans.

But perhaps the studies that are breaking new ground are studies on rimegepant as a preventative.

A study with a super long name (A phase 4, randomized, double-blind, placebo-controlled trial evaluating the efficacy and tolerability of rimegepant for the prevention of episodic migraine in adults with a history of inadequate response to traditional oral preventive medications) observed patients over 12 weeks who took the drug as a preventative (75mg every other day). Once again, these were patients who had had poor outcomes with other medications.

Patients on rimegepant had significantly few “monthly migraine days” than patients on a placebo (patients not taking the drug), and seemed to tolerate the medication well.

There is no medication that works for everyone. But if you haven’t had a lot of success with the medications you’ve tried, don’t give up. There are a lot of options available, and there may be one that works well for you specifically.

The post Updates on Rimegepant appeared first on Headache and Migraine News.

There certainly have been times when I’ve posted more or less depending on a variety of factors. But let’s admit it – it’s been pretty quiet around here lately!

On a personal level, this past year has been one of the most challenging years of my life. Most of you have gone through similar times! I am, however, still committed to reporting on migraine and other headaches, and helping you all wherever I can. And so hopefully I can gradually get back to some kind of equilibrium. But who knows?

The good news is, following many of the tips I have learned over the years – tips you can find here – my head health is probably better than it’s ever been. So I will keep working to share more ideas and tips and resources with you.

I was actually stopping by to give you some news updates. I’ll try to do that over the next few weeks. But then I realized that one of my updates was – well, very current! So let me share with you one of the best resources out there.

That is, the free Migraine World Summit. You can tell I’ve been off the grid if I haven’t mentioned it even here or on social media!

This is a GREAT resource. There is so much information that it’s overwhelming at first. But one of my tips is that you should check out which seminars you want to watch or listen to, and focus on those, instead of trying to watch everything.

The summit is starting today, and runs until the 18th. Each day you can watch the seminars from that day. Click here for the full schedule. Registration is free.

Now scroll down to watch the current interviews with world class experts! For example, tomorrow’s options:

• Mind Your Body: The Role of Emotions in Chronic Pain
• Can Long COVID Cause Migraine or Make it Worse?
• Is Migraine a Sensory Processing Disorder?
• A Whole-Person Approach To Overcoming Chronic Dizziness & Vertigo

With all these great resources available, I won’t take more of your time here. But I hope to be back soon with more!

Note: You can also purchase the summit materials along with a host of related resources with an Access Pass. During the summit, there is a discount on these passes, so be sure to check out this page if the information is useful to you. And from my experience and the experience of many others, it will be!

Purchasing the pass also supports migraine advocates and researchers, including this site. Thank you!

The post A Personal Note appeared first on Headache and Migraine News.

Yes, you heard right. The app will actually be the prescription. A digital prescription. Sort of.

This past week Click Therapeutics reached a milestone when the FDA approved their application for their digital app, currently known as CT-132. It’s an app specifically designed to treat migraine.

No, you don’t inject yourself with it or hold the phone close to your head to make it vibrate. It’s actually more about helping you with lifestyle changes. Yes, we’ve seen things like this before, but this is a specific app that has gone through clinical trials.

This isn’t Click Therapeutics’ first app. They already have an app available for major depressive disorder, known as Rejoyn. The official website explains: “Rejoyn, when used alongside your antidepressant medication, can help you treat depression symptoms differently. It is authorized by the FDA and provides 6 weeks of brain-training exercises and short skills-based therapy lessons.”

They also have an app for type 2 diabetes. And more to come, but the migraine one is coming soon.

We can expect to see more apps of this type coming.

One of the important measurements for an app of this kind is whether or not people will use it, and keep on using it. Only after that can we measure whether or not it’s helping. CT-132 seems to check both boxes, after a few weeks in the trials.

Of course, this is bit of a different kind of thing to test, when we compare it to taking a pill. But so far it does seem to help. But the real trial will come when it’s available and people in the real world start using it.

What do you think? Would you give it a try?

The post Coming Soon: A Prescription App… appeared first on Headache and Migraine News.

Over the past many years that I have written about headache disorders, every once in a while there’s something that helps a lot of people. Everyone is unique, of course, so often it’s the little things that help a few people here and there.

But I’m talking about things that have helped a wider number of people, just based on the unscientific feeback I get. One of those things has been magnesium – a simple thing that has helped a lot of people. We’ve talked about it a lot.

But I’ve also received a lot of feedback on the work of Dr. Josh Turknett. Dr. Turknett is a neurologist who has studied migraine and diet extensively, and he has written two helpful books:

The Migraine Miracle: A Sugar-Free, Gluten-Free, Ancestral Diet to Reduce Inflammation and Relieve Your Headaches for Good

This is an introduction to his research on migraine, with lots of helpful tips. It explains his approach to migraine from the bottom up. If you want to understand more about migraine and learn how to take specific steps to fight it, I highly encourage you to start here.

Keto for Migraine: Keys to the Ketogenic Diet for Migraine Sufferers

Don’t be put off by the title – even if you’re not ready to go hard-core keto, this book helps you design a migraine-fighting diet that could make a huge difference in your life. And, of course, that’s my whole point – these books have helped a wide range of people fight migraine in practical ways.

And here’s a bonus. Migraine isn’t Dr. Turknett’s only interest. He’s interested in a wide variety of good-for-the-brain activities, including music! So if you enjoy his work, be sure to check out Anyone Can Play Music: Unlock Your Musical Potential with the Laws of Brainjo!

The post By Special Request… appeared first on Headache and Migraine News.

It’s about time that we talked about oxalates.

The human body is incredibly complex. A full understanding of how it works and how it’s all balanced together is still far beyond the reach of modern science. And so there’s a lot to talk about.

Oxalates are natural chemicals in your body, and are also found in some foods, such as (you guessed it) spinach, almonds, peanuts, potatoes, chocolate, carrots and raspberries.

Oxalates have become a topic of conversation partly because of the popularity of the book Toxic Superfoods by Sally K. Norton. But the book has also been highly criticized as more health-hype than health-fact.

The fact of the matter is that oxalates have been a concern in the health field for more than a century. As early as 1933, migraine among other things was being connected with too much oxalate intake.

As with anything, there’s too much of a good thing. It’s not so much controversial that too many oxalates collecting in the body can cause problems (such as, most famously, kidney stones).

The controversy instead centres around just how common oxalate problems are, and just what kinds of health conditions they can cause. Some of the criticisms around Norton’s book, for example, are that she seems to associate almost every health condition and the fall of western civilization to eating too many oxalates.

I exaggerate, of course, and I think that some of these criticisms are a bit unfair as well. The fact is that our bodies are indeed complex, and doctors are often very hesitant to blame health issues on diet unless the connection is direct and obvious.

The nature of this controversy means that, if you’re interested in investigating it, you’ll need to do more than watch a couple of videos on YouTube. It will take some time to look at various sides of the issue, and to take a good look at what your body is telling you.

Norton is suggesting (among other things) that in many ways modern health crazes are pushing our bodies out of balance. To suddenly load up on spinach smoothies may indeed be too much of a good thing. And certain diets, in their effort to duplicate and feed our every craving, end up causing two problems as they solve one.

Even the question of which foods will cause problems with your oxalates can be complicated. But if you’re dealing with health issues and want to investigate diet solutions, I recommend looking into this question and making your own decision. Take a look at some of the foods commonly said to be high in oxalates. And do some serious reading of the research.

Norton’s book is one resource you can check out. But be warned that this is not a light, motivational self-help read. To understand her side of the issue, I strongly recommend you take the time needed to understand it. And she does address some of the concerns of her opponents – you can decide if her answers are helpful/satisfactory.

This issue raises some important general questions. Is it hopeless to try to improve our diets? Will the research of 2029 completely change diet recommendations for migraine and other similar conditions that we had in 2024? How can we make the best decisions now without being caught in fads that might not serve us well? Science is a moving target, and it should be, since it’s based on questioning and retesting. But we still want to make the best decisions we can by wisely interpreting the information we have today.

There are some rules that seem timeless, and moderation is one of them. And that may indeed be part of the issue with oxalates. But the human body is much more complex than a “just do this” diet can address. Your body changes as you get older. Rapid industrialization is changing the food that is available to us, meaning that the nutrients in common foods may not be what it was a hundred years ago. Migraine sufferers have specific needs that may not be addressed by “fad diets” anyway.

There are general rules that can be helpful. But in the world today, don’t expect a silver bullet that will solve all your health issues. It’s going to take some work. But we’re up for it!

The post Too Much Spinach? appeared first on Headache and Migraine News.

It’s been over 15 years (!) since I first wrote about the benefits of deep brain stimulation for cluster headache. It wasn’t a brand-new treatment at that time. However since cluster is fairly rare, it takes a lot longer to collect useful information.

A recent publication in BMC Neurology had a review of studies of DBS, both older and newer. And their findings were positive.

You can read the report for yourself (Exploring the potential of deep brain stimulation in managing cluster headache: a systematic review), but here are some important points:

• Not every patient benefited. This is important to say from the start. One of the current and future goals of researchers is to understand why DBS is helpful for some patients and not for others, so that no one has surgery that won’t really help.
• That being said, many patients did benefit significantly. The study notes: “Patients who responded positively to DBS often experienced long-term benefits, with sustained reductions in CH symptoms even after several months to years of follow-up. Quality of life measures consistently showed improvements among responders, suggesting that DBS not only reduces pain but also enhances overall well-being.”
• Adverse effects were usually temporary and not serious. A common one was double vision (diplopia), but again it was usually only a temporary issue, compared to the long-lasting effects benefits of the treatment.
• As mentioned above, “overall well-being” was improved. One notable reason for this was that DBS sometimes seems to cut down on nighttime cluster attacks, improving sleep. That’s a huge benefit.

Research will continue, but in answer to the question “how’s it going?” – it’s going well. Deep brain stimulation is still beneficial to many cluster headache patients.

For a good overview of deep brain stimulation in general, see this article from the Cleveland Clinic.

The post Cluster Headache and Deep Brain Stimulation: How’s it going? appeared first on Headache and Migraine News.

It’s hard to believe that it has now been seven years since the FDA approved Ajovy (fremanezumab-vfrm) for migraine. But seven years it has been. And this month it has been approved for paediatric use for those with episodic migraine (more information).

Ajovy is one of the CGRP related medications (a calcitonin gene-related peptide antagonist in this case). It’s a preventative, taken by injection. The word “injection” may scare a lot of people off, but the nice thing about Ajovy is that it’s only taken once a month – or, over the course of a day every three months. It also uses an “autoinjector” which is fairly easy to use, unlike old-fashioned needles (been there!).

It’s not surprising that many people prefer something taken every three months to a pill taken every day. And Ajovy continues to be a success story for many, significantly or even drastically reducing their days with migraine symptoms.

Appropriately, we are a lot slower to approve medications for children. But Ajovy now provides another option for many children suffering from migraine, and in this case something that won’t be a daily complication.

The details? Ajovy has been approved for children ages 6-17, who weigh at least 45kg or 100 lbs. The quarterly injections have not been approved, only the monthly injections – a dosage of 225mg (the same as the monthly dose for adults).

The weight of the patient is an important factor, because we still don’t know of a dose that will be effective and yet still safe for lower weights.

As with trying any new medication, you should watch for any unwanted symptoms. Some people have reported skin problems around the injection site, something that can probably be treated to diminish the discomfort. Be sure to talk to your doctor if you have any concerns.

For more information, see Ajovy’s official site. There is also some detailed information at the FDA official site on Ajovy.

The post Ajovy for Children and Adolescents appeared first on Headache and Migraine News.

There are a host of available apps available to remind you to take your meds. Every one of them has its pros and cons. But here are a few to consider…

First, I should note that although I use a ridiculous amount of apps on my phone, I hate to add another app that can do something that I can already do with an app I already own.

If you have an app for your to-do lists, or a calendar, or even a notebook app that allows reminders (such as Evernote), you can set it up to remind you to take your medications. Apple’s Health app also has a medication reminder feature.

Second, I should admit that I’m not fond of subscription apps. I know why they exist, it entirely makes sense as a business model, but I just don’t have the cash to keep doling out more each month. But more power to you if you find the perfect subscription app.

For example, for years I used Medisafe Pill Reminder, and it’s excellent. I recommend it. But when it went to a subscription model, I began looking elsewhere.

There are also specific migraine trackers, that can track the medication you take, and even remind you to take preventatives. N1-Headache is one of these – an excellent app that especially excels in finding your true triggers. We’ve talked about it before – also highly recommended.

If, however, you want something more focused on medications, here are a couple of suggestions. I should also add that I’ve used apps like these for family medications. If you want to keep track of a parent’s meds or a child’s or whatever, this is the way to go.

MyTherapy Medication Reminder is a highly customizable medication reminder. You can add personal notes, get reminders when you need refills, “game-ify” your treatment by earning rewards, and even track symptoms and general health information. Also, you can easily export information for your doctor.

This much ability to add information and customize means that you could actually track things like headache level, giving you a lighter-weight way to track all meds but also specifically some headache info.

But the app that I’ve settled on at this point in my life is Pill Reminder – All in One. This is an extremely flexible app in which you can add multiple users, multiple medications (including abortive “as needed” meds – perfect for migraine), unique sounds for your alerts (which I really like), and easy-to-read views. It also has many of the additional features I mentioned for the previous app, such as exporting information for your doctor.

This one has a very small one-time cost if you want to add more than two alerts.

And here’s another bonus – no data is collected at all from this app. Privacy is a priority.

There’s no reason why you can’t download a couple of these and try them out to see what works best for you.

If you’ve found something else you love, leave a comment!

The post Medication Apps appeared first on Headache and Migraine News.

We’ve known for a long time that people with migraine tend to respond differently to visual stimuli. But we’re not the only group.

As a matter of fact, Dr. Daniele Piscitelli (Department of Kinesiology, University of Connecticut) didn’t start out studying migraine, but studying stroke. But he noted that there was some overlap with migraine research.

So he started studying migraine and cortex excitability – that is, how the brain responds to stimulation. He studied motor excitability – related, of course, to body movement, and visual excitability, related to what we see. The findings were published in the journal Restorative Neurology and Neuroscience.

Without getting into the details (which you can read in the actual study, Effects of Pattern-Reversal Visual Stimulation on Brain Activity in Migraineurs and General Population), the researchers didn’t find any difference in motor cortex excitability between the control group and the migraine group. However, the migraine brain did tend to have more visual cortex excitability.

This is all very technical, of course, but it does confirm some things. For one, the researchers found that this was the case not only with migraine but with other types of headaches. We’ve known for a long time that tension-type headaches and migraine aren’t so different after all, and may even have a common basis. This confirms the connection again.

Another thing we’ve known (and not completely understood) is that there’s a link between epilepsy and migraine. Some drugs common to both can reduce visual cortex hyperexcitability. So if your doctor recommends an anticonvulsant drug for your headaches, they’re on solid scientific ground (although of course every person is different when it comes to which medication, if any, they should take).

This is only another study in a long line that are helping us understand how migraine works and how it’s related to other conditions.

To read more, check out the press release from the University of Connecticut: Migraine sufferers’ brains respond differently to visual stimulation

The post Migraine and Visual Cortex Excitability appeared first on Headache and Migraine News.

Shades for Migraine is back for another year!

If you’re not familiar with this campaign, Shades for Migraine encouraged people to wear, you guessed it, shades – sunglasses – on the 21st of June (this Saturday), to raise awareness.

I love their video and graphic – this graphic shows some of the “hidden” reality of migraine (click to see the full version on their site):

The video clarifies:

So, this Saturday is your chance to get involved! Feel free to post a picture and tag it #ShadesforMigraine – or, just start a conversation with your ordinary, or even crazy and wild – sunglasses!

For more information, go ahead and visit:

Shades for Migraine

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