Headache

Experimental Migraine Drug Brings Fast Relief

New drugs block a chemical in the nervous system that causes inflammation and blood vessel dilation, spiking in the brain during migraine attacks

Experimental Migraine Drug Brings Fast Relief - An experimental drug may bring fast relief to people with debilitating chronic migraines, a new study finds.

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Preliminary trials had already found that the drug dubbed TEV-48125 can help prevent migraine attacks in people who've suffered long-term with headaches.

Now, the new findings suggest that it starts working within three to seven days of the first injection, researchers reported.

"To my knowledge, that's the fastest separation ever demonstrated in chronic migraine," said lead researcher Dr Marcelo Bigal, of Teva Pharmaceuticals, the company developing TEV-48125.

The term "separation" refers to the point at which patients on TEV-48125 started to improve, compared to patients given a placebo (an inactive treatment).

TEV-48125 is one of a new class of drugs being developed to prevent migraines. The medications are all antibodies that block a chemical in the nervous system called CGRP. Research has found that CGRP causes inflammation and blood vessel dilation, and it spikes in the brain during migraine attacks.

Exciting findings

Dr Mark Green is professor of neurology and anaesthesiology at the Mount Sinai Icahn School of Medicine, in New York City. "It appears that this antibody works quite quickly," said Green, who is also director of the Centre for Headache and Pain Medicine at Mount Sinai.

Green, who was not involved in the study, called the findings "exciting". That's in part because if CGRP-blockers make it to the market, they would be the first drugs specifically designed to prevent migraines.

About 12 percent of Americans suffer from migraines, according to the U.S. National Institutes of Health. The headaches typically cause an intense throbbing pain on one side of the head, and sensitivity to light and sound. Some people have nausea, too.

Migraines are considered chronic when they strike at least 15 days out of the month, the study authors said.

Doctors prescribe various medications that can help prevent frequent migraines including certain blood pressure drugs, antidepressants and Botox injections. But, Green pointed out, all of those drugs were originally designed to treat other conditions. Over the years, doctors have found that they can also reduce migraines in some people.

Reanalysis of an early trial

And of those drugs, Botox is the only one that is actually approved for preventing migraines, Green said.

When Botox works, it typically takes two or three rounds of injections for patients to start seeing the benefit, according to Green. And those treatments are done at three-month intervals. So some patients give up on it, he said.

The oral medications used for migraine prevention kick in faster – typically four to six weeks. But they are also daily pills with potential side effects, such as weight gain, dizziness and fatigue (depending on the medication), Green said.

The new study findings come from a reanalysis of an early trial of TEV-48125. In that study, more than 250 patients with chronic migraine were randomly assigned to take monthly injections of the drug – at a higher or lower dose – or a placebo, for three months.

The original study found that patients on TEV-48125 saw a drop in the number of hours they had headache pain each month.

Few side effects

On average, the whole study group had 162 "headache hours" a month when it started the study. Three months later, that had dropped by 60 to 67 hours, on average, among patients on the new drug.

The new study found that the effects started as early as three days after the higher-dose injection, and seven days after the lower dose.

So far, Green said, there have been "no significant safety signals" with the drug. In the original study, the most common side effects were pain at the injection site and skin irritation.

But it's still early, Green stressed

Bigal said ongoing studies will keep looking at the drug's safety. "No treatment-related serious adverse events have been seen so far," he said.

If TEV-48125 or its competitors are approved, it's unlikely that patients will be put off by having to take a monthly injection, according to Green.

"These are people in chronic pain," he pointed out

But cost could be an obstacle: In general, antibody drugs like TEV-48125 are very expensive. So patients might find it difficult to get insurance coverage, Green said.

The study was published online in Neurology.

Read more : How to handle ramadhan headaches

How to Handle Ramadan Headaches

Ramadan is a sacred, spiritual time for Muslims around the world but fasting can cause headaches. This is how you can prevent and manage headaches during this holy month

How to Handle Ramadan Headaches - Ramadan is a sacred time for Muslims worldwide. During this one-month period Muslims fast from sunrise to sunset.

Studies have shown that the religious practice of fasting (abstaining from eating, drinking or smoking) can often lead to mild or moderate headaches. Fortunately for those that get headaches during Ramadan, there are some ways to help prevent headaches during Ramadan.

Research shows that Ramadan headache onset often occurs in the afternoon or evening just before the fast is broken. Headache frequency typically increases over the duration of fasting. Those prone to headaches at other times of the year are most likely to get a headache when fasting, but some patients who experience headaches during this time often have no previous history of headaches or migraines.

Dr. Elliot Shevel, South Africa’s migraine surgery pioneer and the medical director of The Headache Clinic, says headaches during fasting can occur as a result of a few factors such as low blood sugar, increased stress, and caffeine withdrawal.

The good news is that you can manage these headaches without breaking your fast.

1. Caffeine withdrawal

Caffeine withdrawal is a common cause of headache while fasting. “Patients can often prevent headaches by reducing caffeine consumption in the weeks leading up to their fast,” says Shevel. A cup of strong coffee just before the start of the fast each day may also prevent caffeine withdrawal headache.

2. Hypoglycaemia

Hypoglycaemia (low blood sugar) can also trigger headaches in many people. If a meal with high sugar content is taken before the fast begins, it can cause a rapid rise in blood sugar levels, followed by a fast drop that may trigger a headache, explains Shevel.

“Eating a meal with low sugar content before the fast may prevent the onset of a headache during the day.” Contact The Headache Clinic for a list of foods which have a low glycaemic index.

3. Dehydration

Dehydration is another common trigger and adequate intake of fluid before the onset of the fast can often prevent headaches.

“The human brain consists mostly of water, and it is very sensitive to the amount of water available to it. When the brain detects that the water supply is too low, it begins to produce histamines,” explains Shevel.

This is essentially a process of water rationing and conservation, in order to safeguard the brain in case the water shortage continues for a long period of time. The histamines directly cause pain and fatigue, in other words a headache and the low energy that usually accompanies it. Make sure to drink large amounts of water before starting your fast and when you end it.

Avoid triggers

“Patients should also, as far as possible, try to avoid exposure to other triggers such as stress, fatigue and lack of sleep during their fast, when there is a greater tendency to experience headache,” says Shevel. “Rest and sleep often help prevent being subjected to headaches and the pain often melts away when the fast is broken.”

When to call your doctor

If headaches are interfering with your fast, contact The Headache Clinic as we have a number of techniques to relieve you of your pain. This will allow you to continue your fast without having your focus be overtaken by persistent headaches. If headaches persist after the fast or are severe in nature, patients are advised to seek help from a medical professional. Shevel explains that headaches can be most successfully treated using a multidisciplinary approach, since no one medical specialization covers all the psychological and physical dimensions of severe headaches.