It begins with flashes of sunshine. Zig-zag traces float throughout your imaginative and prescient. You’re feeling a slight tingling in your cheeks and limbs. Then comes a stabbing headache so intense you overlook the whole lot—what you have been doing, the place you might be, and the right way to compose your self.
Scientists nonetheless don’t absolutely perceive why migraines occur. Not like boring complications throughout a chilly or pulsing complications after an evening of overindulgence, migraines are debilitating and strike at seemingly random occasions. Stress, lack of sleep, and shiny lights might spark an assault—however the triggers differ between individuals, making them laborious to foretell.
Regardless of a long time of analysis, few drugs can be found. However a stunning newcomer might change the sector. Referred to as liraglutide, the drug is in the identical household because the blockbuster weight-loss medication Ozempic and Wegovy, which have taken the world by storm.
In a small trial of 31 individuals with continual migraines who didn’t reply to different remedies, liraglutide slashed the variety of days they skilled migraines by over half. The drug labored remarkably quick, with most individuals feeling aid inside the first week.
Though the volunteers have been overweight—which will increase the possibility of migraines—subsequent evaluation confirmed the drug lowered migraines even with minimal weight reduction.
“Liraglutide might function through completely different mechanisms [than weight loss], and characterize a promising new method to migraine prevention,” wrote the workforce.
Headache on Headache
Migraine has been a headache to review for many years. Though it impacts almost 15 p.c of individuals worldwide, its origins within the mind stay principally mysterious. The situation isn’t only a extreme headache—individuals additionally expertise nausea, dizziness, and sensitivity to gentle, sound, and odor.
Scientists initially thought migraines occurred due to blood vessel issues within the mind and handled the complications with commonplace ache drugs. However these don’t work nicely. Current research paint a much more complicated image of the situation. Migraines appear to stem from dysfunctional neural networks in sure mind areas, the place neurons launch messengers known as neuropeptides that spark irritation and dilate blood vessels within the mind.
These chemical substances doubtlessly enhance intracranial stress—that’s, the mind urgent towards the cranium—and will act as a set off for migraines.
Scientists investigating neuropeptides have already designed a migraine therapy. Referred to as anti-CGRP medication, these drugs could be injected into the bloodstream to deal with or forestall continual migraine assaults. One managed medical examine in 667 sufferers discovered that those that obtained injections skilled fewer days of head-splitting ache.
Though these medication are efficient and have comparatively delicate negative effects, they’re costly. This motivated the workforce to search for one other technique to decrease mind stress.
Chemical Polymath
Enter GLP-1 agonists. Most famously represented by Ozempic, these medication skyrocketed to fame for his or her skill to slash weight, handle diabetes, and decrease the chance of coronary heart illness.
That’s not all they will do. The medication goal proteins known as GLP-1 receptors, that are dotted on the surfaces of a number of cell varieties, together with neurons, suggesting that past managing weight, they might regulate the mind too. One examine discovered that day by day injections of a GLP-1 drug slowed cognitive decline in individuals with delicate Alzheimer’s illness. One other trial advised the medication might deal with alcohol dependancy. How they work continues to be beneath investigation, however these medical trials counsel GLP-1 medication can impression the mind by means of chemical signaling, or maybe stress.
Earlier research discovered the medication tinker with the quantity of fluid within the mind. The organ is bathed in a nutritious soup known as cerebrospinal fluid, which cushions it and removes waste. However the fluid can construct up and enhance intracranial stress—doubtlessly resulting in migraines.
GLP-1 medication may decrease that stress. An early examine discovered a drug normalized dangerously excessive mind stress in rats, like deflating an overblown balloon. A small randomized medical trial in individuals with excessive intracranial stress discovered the drug almost restored it to regular.
These promising outcomes led Simone Braca on the College of Naples Federico II and colleagues to check liraglutide, a GLP-1 drug, as a therapy for continual migraine. All 31 individuals within the examine have been roughly middle-aged, overweight, and had already tried a minimum of two different medication with none enchancment of their signs.
“Weight problems can worsen migraine by growing headache frequency and decreasing response to straightforward preventive remedies,” wrote the workforce.
Every participant obtained a day by day injection of the drug for 12 weeks. Additionally they stored a “headache diary” to trace their migraines and log any potential negative effects.
Virtually everybody reported fewer days with migraines. On common, their complications dropped from 20 days a month to roughly 11 days. Some individuals reported that the times they’d complications fell by roughly 75 p.c. One participant remained utterly migraine-free after the primary injection and for the remainder of the take a look at interval. Others weren’t so fortunate: 4 individuals didn’t reply to the therapy, suggesting it’s not a common cure-all.
Those that benefited, nevertheless, stated the drug improved their high quality of life in only a week, regardless of minor negative effects. Roughly 40 p.c of individuals skilled nausea or constipation, each of that are widespread negative effects for these taking GLP-1 medication. The signs ultimately went away.
As anticipated, the individuals dropped a couple of kilos, however further statistical evaluation discovered the load loss didn’t contribute to migraine frequency. This implies the impact of GLP-1 medication on migraine “is impartial of their weight reduction impact,” wrote the authors.
On the Starting
The workforce is simply beginning to untangle how GLP-1 medication combat migraines. As a result of they decrease intracranial stress, the photographs may scale back the quantity of the neuropeptide CGRP pumped out within the mind. Present anti-CGRP migraine medication decrease irritation and scale back intracranial stress, and liraglutide may need related results.
GLP-1 medication may play with salt and potassium ranges within the mind, which controls how neurons activate. Tinkering with these ranges might doubtlessly alter a neuron’s skill to fireplace, altering the mind’s capability to launch CGRP and different neuropeptides.
Additionally, the examine has limitations price noting. Every participant knew they have been receiving the drug, so placebo results might have clouded their judgement. Though they skilled advantages for 12 weeks, an extended follow-up interval might higher gauge if the advantages final. And since the trial solely recruited individuals with weight problems, the outcomes might not generalize to a broader inhabitants.
The workforce is already planning a big randomized managed trial. “As an exploratory pilot examine, these findings present a basis for larger-scale trials” that study the position GLP-1 medication might play in migraine administration, wrote the authors.
