Haims column: Migraine — new information can make your head buzz
Migraines are not the same as a headache. Although many people may say that they have a migraine, in actuality, they may only have a headache.
While a headache may hurt, often for a short while, a migraine can cause indescribable pain and frequently be incapacitating.
Of the many different types of headaches, the most common are: sinus, tension, medication-overuse (from painkillers), caffeine related, menstrual, head injury, and of course — the hangover. Most of the time, such headaches are short in duration and do not cause pulsing/throbbing pain, nausea, visual symptoms, and neck pain that is common with migraines.
For those that suffer from migraines, the recent announcement from the FDA of a newly approved drug that may offer relief is exciting. Unfortunately, it comes with a big price tag. Aimovig, produced by the biopharmaceutical company Amgen, will be made available at a cost of $575 per injection. In general, one injection is needed per month.
Aimovig is an antibody produced in a lab. Similar to the antibodies our immune system makes to attack viruses and other intruders, this antibody was specifically designed to attach onto receptors in our body that interact with a protein called CGRP-R.
This is the first FDA approved medicine to block the Calcitonin Gene-Related Peptide – Receptor (CGRP-R). In order to understand what the medicine does and how it works, you’ll need to understand a few terms.
• Antibody: An antibody is a protein produced by the body’s immune system. They protect us from harmful invaders such as bacteria, fungi, parasites and viruses.
• Peptide: Peptides are a short chain of amino acids — usually between 2 and 50 amino acids — whereas proteins are made up of 50 or more amino acids.
• Trigeminal nerve: The trigeminal nerve is a nerve responsible for sensation in the face and motor functions such as biting and chewing.
Many people incorrectly believe that the cause and pain of migraines results from the dilatation of blood vessels. The pain of a migraine occurs because CGRP is released and binds to the trigeminal nerve. As our brain does not have the ability to feel pain, the trigeminal nerve passes the sensation of pain on the brain’s behalf. So while blood vessel dilation does occur with migraines, the dilation is not the cause of pain.
Aimovig’s success is based on the belief that the medication will block CGRP from its receptors and thereby keep pain at bay. This is exciting as further research may find that CGRP-blocking antibodies can prevent other pain-related issues.
According to Michael Moskowitz, a migraine researcher at Harvard University, “If CGRP fulfills its promise as a blockbuster pain target, that success could signal to drug developers that effective treatments for other complex and seemingly intractable pain disorders, such as fibromyalgia, are also within reach.”
This new medicine does not claim to eliminate migraines, but it has proven effective in reducing the frequency and duration of the symptoms. At this time, Aimovig’s pros seem to outweigh the cons. However, there is concern about the side effects of blocking CGRP receptors. Possible side effects include pulmonary and cardiological concerns along with wound healing.
Other migraine treatments currently available also have side effects. So, currently, there are no silver bullets for those afflicted with migraines. Education and a willingness to try a variety of treatment options may prove beneficial for many people.
Some known therapeutic treatments include acupuncture, massage therapy, biofeedback and dietary changes. Herbs and vitamins have also shown to be helpful and often have few if any side effects. Feverfew, buckwheat, flaxseed, magnesium mallet, CoQ10 and melatonin have been found beneficial in reducing headache pain.
While some people are predisposed to headaches and migraines, having some knowledge of common triggers could be beneficial. Below is a short list of common triggers:
• Diet — aged cheeses, salty foods, MSG, aspartame, nitrates, nitrites
• Alcohol — especially wine, and highly caffeinated beverages
• Skipping meals
• Hormonal changes, menstrual cycle
• Changes in the weather
• Inadequate sleep
If you suffer from frequent headaches and/or migraines and think you may be a candidate for this new type of migraine medication, you should talk with your doctor, neurologist or headache specialist. They can assist and educate you about the options that are best suited for your personal needs.
Judson Haims is the owner of Visiting Angels Home Care in Glenwood Springs, Basalt, Aspen and the surrounding areas. He is an advocate for our elderly and is available to answer questions. His contact information is, http://www.visitingangels.com/comtns, 970-328-5526.
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