
FDA approves new treatment for adults with migraine - apsec112
https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-adults-migraine
======
DailyHN
Growing up, I had multiple friends die from brain aneurysms. Those start with
a bad headache.

That has lead to me avoiding all medicines every time I get a headache (yes, I
understand correlation is not causation).

My primary route to solve any headache is hydration. Adding electrolytes is
also important because too much water without them can also give you a
headache.

My experience has also lead me to focus on consuming the healthiest diet I can
find (currently intermittent fasting + keto with intermittent-vegan weeks,
mostly organic, with all nutrients from food sources).

On the other hand, my mother, who could convince the majority she's healthy
based on her weight and latest diet buzzwords, has had migraines for the past
30 years, maybe longer — even landing her in the hospital on many occasions.

A migraine is your body telling you something is wrong with your most valuable
asset.

Are you sure you want to sweep this problem under the rug?

There is a documentary on Amazon called "Fat". It illustrates how many
children with epilepsy were harmed by the combination of 1. lack of
understanding food and 2. pharmaceuticals with side effects that render them
permanently disabled.

Good luck with your search for health and wellbeing.

~~~
BiteCode_dev
Indeed. Migraines for 30 years. Painkillers allows you to keep up with
whatever wrong you are doing.

So if you have migraines, it is not normal. It is not incurable either. Use
pain killers when you must, but keep looking for a solution.

The solution can be different for everybody. Start with diet, it's a very
common cause for it. Don't limit yourself to what you think is right. Try
things, even weird ones. Took me 3 decades of trials and errors to not need
pain killers.

~~~
fgonzag
If pain killers worked for your migraines, they were extremely mild migraine.

OTC pain killers (and even prescribed pain killers) don't really do anything
for the 3 people I know that get migraines. These people have to lay down
under their sheets to block all sun light, they can not do absolutely anything
at all during the episode but block sunlight and hope whatever medicine sort
of worked last time will work this time.

Preaching and generalizing from your mild case helps no one.

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kyle_morris
I’ve had migraines since I was a kid and have been fortunate to have
identified my triggers(caffeine/cacao) and found medication that works when
one comes on.

I can’t imagine how awful it is for folks who have no respite and hope this
treatment can provide some relief.

~~~
coldcode
I used to get horrible migraines from high school age on, my triggers were
bright reflections and too much MSG (I kept track of what I ate and then tried
to avoid anything that triggered) and generally I was useless for at least 4
hrs several times a month. If I was really quick a single Vicodin would at
least make it manageable but generally I could keep nothing down. As I got
older the headache itself got less and less and mostly what I get now is the
aura (freaky lightshow in your eyes) and a single Tylenol is fine. But for 20
years it was not a fun experience at all. I know people with way more
frequency to the point of being unable to do much at all.

One summer in college for a month I got a cluster headache every morning. 20
minutes of absolute agony that made migraines seem like a walk in the park.
Thankfully those never came back.

I am glad research has been finding more ways to treat and even stop them.

~~~
shantly
> As I got older the headache itself got less and less and mostly what I get
> now is the aura (freaky lightshow in your eyes) and a single Tylenol is
> fine. But for 20 years it was not a fun experience at all. I know people
> with way more frequency to the point of being unable to do much at all.

I also started getting mine in high school (sophomore or junior year, I
think?). Never had them frequently, just once or twice a year, which is
plenty. I too have noticed a shift in their effect as I get older, away from
my predictable blind-spots-followed-by-pain to a wider variety of visual
effects and usually just feeling really weird and "off" for the rest of the
day.

Oddest one so far involved fairly bad tunnel vision, which was new and I've
not had again since, plus the usually just-off-center-of-vision blind spot I
get, followed about a half hour later by needing to sleep. It wasn't the same
feeling as being very tired, exactly, but I just _needed_ to get in bed and go
to sleep. No pain, just that. So weird.

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AmericanChopper
Diclofenac works very well for me. Tablets work within an hour most of the
time, and intramuscular shots work within about 20 minutes every time. But the
long term potential side effects aren’t great, so new options would be
fantastic.

~~~
dillonmckay
How do you get the shot, logistically?

Once I have a migraine, travel is exceedingly difficult for me.

~~~
AmericanChopper
It was always terrible. I used to live half a block from my doctors office, so
I’d just (slowly) walk then. Now my wife will drive me (probably only need a
couple of them a year though).

Basically it just sucked. Especially sitting in the bright waiting room,
sweating bullets, trying not to throw up before I was seen. My most serious
migraines can last a couple of days, and are just awful. Making it go away
almost instantly was alway worth the hour or so of additional suffering to get
a shot. I’ve also got a rather high pain tolerance, and tend to only get worn
down by pain that lasts a long time.

I don’t know if it would be as effective for anybody else, but if you get
migraines that seem worse than death, I’d recommend asking your doctor about
it.

~~~
ta999999171
How does cannabis affect your symptoms, if you vaporize some of that instead
of heading for the Dr?

~~~
AmericanChopper
I only smoked weed when I was young, but it would generally make it worse (and
would sometimes add nausea). I have some pretty good pain management
techniques I use, and I think being high just takes my focus off them. I also
can’t stand the dopey feeling and won’t even take opioids unless I really need
to. I broke my leg a while ago and limped home on it thinking I’d just
sprained it, eventually went to the ER and it took about 18 hours after the
accident until I gave up and asked for some tramadol. The downside is, if I
tell a nurse or doctor that I’m in extreme pain, they tend to not fully
believe me because I’ll look quite calm.

~~~
nython
Would you mind elaborating on the pain management techniques?

~~~
AmericanChopper
Mostly slow deep breathing and focusing on relaxing and trying to lower your
heart rate, basically just trying to calm down. Pain is just signals in your
brain like any other though or feeling. I’m pretty convinced you can exert a
reasonable amount of control over it. I’m no expert on the subject and I
haven’t trained to do it or anything, I’ve just injured myself a lot and
that’s what has worked for me. It’s gotten me through a fair amount of serious
injuries without much stress, the only trouble I’ve found is that I need to
continually focus on doing it, and if I’ve been up in the hospital all night,
I’ll eventually get worn out and exhausted, and it won’t work quite as well.

I don’t think there’s any limit to how proficient you can get at it. I think
about that Vietnamese monk who set himself on fire and managed to calmly sit
through burning to death, there’s no way anybody could do that without having
total control over their pain response. I’ve obviously never experienced
anything that traumatic, but I have been in situations where I felt the
symptoms of shock setting in and managed to calm myself down enough to get on
with things.

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natdempk
Does anyone know if they publish details about the size/strength of the effect
anywhere or a link to the actual numbers for the study population?

~~~
lanewinfield
Looks like it "works" (2-hour pain free marker) for ~10% of people.

[https://www.evaluate.com/vantage/articles/news/snippets/ubre...](https://www.evaluate.com/vantage/articles/news/snippets/ubrelvys-
winner-not-long)

~~~
nharada
It might not sound impressive, but I think this is great news for two reasons:

1) Even if only 10% of people respond, this is likely going to give thousands
of people for whom nothing else works a drug that actually does something.

2) Nearly all existing migraine meds fall into the "triptan" class of drugs.
This is an entirely new class (CGRP antagonist), and may pave the way to new
treatments even if this specific iteration isn't as effective as future ones.

~~~
ekianjo
for 2), this is not news, back in October 2019 Lilly got their drug approved
as well in this class:
[https://www.bloomberg.com/news/articles/2018-09-28/eli-
lilly...](https://www.bloomberg.com/news/articles/2018-09-28/eli-lilly-
migraine-drug-approved-and-will-be-free-to-patients)

~~~
Tharkun
The news here is that ubrogepant is a tablet taken as an abortive, while
emgality etc are injections taken as a preventative.

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__tg__
I've had migraines for 40 years, and suffered much before being prescribed
Sumatriptan. It relieves the migraine completely in about 30min. Doesn't work
for my wife who also has migraines but an alternate formulation, Rizatriptan,
does. My migraines have also evolved over the years from intense day long
affairs to duller 3-day ones. Sometimes I need a subcutaneous triptan shot
which relieves it in, I kid you not, 1 minute.

I tried preventative medications but the cure seemed worse than the disease.
One, Topiramate, made me forget things and lose my train of thought. No thank
you.

I also tried keto for a while and noticed that I hardly had any migraines
while on it.

There are a lot of options available now. If you suffer from migraines, go
talk to a neurologist with current knowledge, not something they learned 30
years ago.

~~~
ComputerGuru
Topiramate (topomax) is the antidote worse than the disease. It turned me into
a zombie, literally living in my head but too dead to even open my mouth to
say “hi” or “good morning” when I made eye contact with a stranger (yes, I’m
from the Midwest and we do that here).

(Venlafaxine on the other hand is like a shock collar wrapped tightly around
your brain waiting for you to miss a dose by even two hours, after which it’ll
punish you for the next twenty four hours with electric shocks and spasms _in
your freaking brain_. It’s a real pity it actually kind of worked :/ I still
don’t know if I would ever do it again.)

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latchkey
About a year ago there is this one...
[https://www.theguardian.com/science/2018/jul/31/first-
ever-p...](https://www.theguardian.com/science/2018/jul/31/first-ever-pill-to-
prevent-chronic-migraines-approved-by-eu)

------
lawn
I've also had migraine on-and-off, and I had one even this night. So I went up
and took my medicine, and I can function fairly well today.

Before I had this medicine the whole day would've been ruined, and I would be
very inefficient and lazy tomorrow as well. While I don't get migraine that
often, it makes a world of difference when I do get them.

~~~
learnstats2
Triptans changed my life in this way.

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jobaoana
Moderate to heavy doses of psilocybin at quarterly intervals can eliminate
migranes and cluster headaches.

~~~
AstralStorm
They are somewhat chemically similar to triptans, and consequently usually do
not work for migraines resistant to triptans. But then, there's a lot of
variance there.

But yes, they do sometimes work and when they do it's relatively long term
compared to regular triptan use. And allegedly they're much more potent,
especially when it comes to aborting migraines. Some non-hallucinogenic
chemical variants are being also researched, both of psilocybin and LSD. LSA
has also shown effectiveness sometimes.

At least 3 phase 1/2B-style RCTs of hallucinogens are under way. (Finding
working doses, schedules, cataloguing side effects.) Expect results of one for
psilocybin mid 2020. There's also long running RCT of LSD, finishing in 2023.
I think both of these are for cluster headaches rather than migraines, but
close enough.

Pilot trials have been done a long time ago by MAPS, with success. Now it's
time for bigger science.

The link is also somewhat interestingly tenuous with ECT and seizures. (In
that migraines and seizures rarely coexist, but share symptoms in some cases.)

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fnord77
had to go to wikipedia for the MOA

> It is a small-molecule calcitonin gene-related peptide receptor antagonist

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Cougher
If only someone would remove the headache of pharmaceutical companies
artificially increasing the costs of drugs, particularly when drugs like
triptans reach the generic market.

