January 18, 2020

Several New Migraine Treatments Near FDA Approval

The United States Food & Drug Administration is likely to approve several promising new migraine treatments in 2011.   The treatment perhaps closest to market is the Zelrix patch, manufactured by NuPathe Pharmaceuticals.   According to NuPathe’s web site,

Zelrix utilizes SmartRelief, our proprietary transdermal delivery technology. SmartRelief consists of a controlled delivery technology that uses a mild electrical current to actively deliver medication through the skin in a process called iontophoresis.

zelrix transdermal patchAs you can see, the Zelrix patch looks like a large bandage with batteries and electrodes embedded therein.  The batteries generate a mild electrical current to push the medicine into the skin.   Patients who participated in one of the clinical trials enjoyed the benefit of an effective medication but did not experience the nausea and queasiness associated with traditional oral medications.


Another pharmaceutical company, Map Pharmaceuticals of Mountain View, California, is developing a mist inhaler designed to infuse the drug dihydroergotamine (DHE) into the bloodstream.  DHE is considered one of the more effective drug treatments for migraines, but it must be administered intravenously.  If Map Pharmaceutical’s formulation (called Levadex) is approved, more migraine sufferers will have access to DHE without many of the unpleasant side effects associated with current treatment.  Map has also developed a new style inhaler device called the Tempo inhaler designed to deliver medicine more effectively than current inhaler technology.

New technologies like the Zelrix patch and the Tempo inhaler offer promise to migraine sufferers who cannot tolerate oral medications (pills) or who do not respond to currently prescribed medications.   Most migraine headache Social Security disability cases involve assertions that the claimant’s severe headaches cause numerous unscheduled breaks from work and significant problems with attention and concentration.

Until new and effective treatments become widely available migraine patients will continue to qualify for disability benefits based on debilitating migraine headaches.

Dependence on migraine drugs may lead to more migraines

What if the medicine you were taking to remedy a chronic condition or disease was actually causing your illness to worsen, or even causing another condition to develop?  That is exactly the idea behind some recent studies that have shown that some medications used to treat headaches, especially migraines, may be actually contributing to the problem.  Many people who take triptans for migraines end up developing headaches that can be attributed to these drugs.  In fact, according to ABC News, approximately four million people may suffer from medication-overuse headaches, as well as “rebound” headaches that occur when a medication wears off.

In a study of 160,000 patients, Dr. Lipton, from the Montefiore Headache Center at the Albert Einstein College of Medicine, found that approximately two percent of individuals who take migraine medication at least three times a month may become dependent on the drugs.  This dependency causes them to develop more migraines, and as such, they may have to change medications or treatment options.  But, these medications provide such great relief in the interim that it is difficult to give them up.  What can an individual do when he/she is suffering from such debilitating headaches without relying on medication?  ABC News offers some suggestions about how to manage migraines without drugs.  These guidelines may also help people to function better, as they will not have to suffer through medication side effects in addition to the migraine pain.

First, try to keep a routine schedule, which means the same bedtime, mealtime, and wake up time every single day of the week, including weekends.  This means avoiding sleeping in on weekends or rainy days, and avoiding big changes to this schedule whenever possible.  Next, try to keep a journal detailing what foods provoke a migraine and then avoid those particular items.  Don’t want to go through trial and error of finding what foods cause headaches?  Then, get a food list from the American Council on Headache Education and try to limit your consumption of these items.  It is also suggested that you exercise moderately and often.  In this same vein, you should avoid smoking and manage or avoid stressful situations.  Finally, try to get evaluated for any neck or jaw pain, as there could be an underlying cause of your headaches that is easily fixed with a neck pillow or a mouth guard.  If a headache has already developed, you can apply ice to the head and temples, and heat at the neck to stave off further pain.  Although all of these suggestions may not work for every migraine, they may help to curb some of the pain and may also result in fewer instances of medication overuse.

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