The high expectations for CGRP-blocking migraine medications could turn into a craze before they even get to the market.  New research has raised the hope that this type of medication could fight obesity and diabetes, and help the patient to live longer in general.

New Migraine meds and obesity

Before you start looking to these new meds as the fountain of youth, there are a few things you should know about the study, published this May in the journal Cell.

First, this is a very early study, using mice, not humans.  And it all revolves around TRPV1 pain receptors.

When these pain receptors were destroyed, the mice actually did better as they aged.  In fact, they lived 14% longer than the other mice.  More insulin became available, and blood glucose lowered.

What would that mean for a human being?  Less chance of obesity of type 2 diabetes, because your body would easily be able to get rid of sugar.

What does this have to do with the new series of migraine drugs that researchers are working on?  Well, the calcitonin gene-related peptide neurotransmitter – CGRP – is blocked using the new medications.  CGRP is triggered by the TRPV1 pain receptor.  Meaning that the blocking of CGRP may be the real key.

Interestingly, this particular pain receptor is sometimes called the “capsaicin receptor”, because it’s activated by capsaicin, the active ingredient in hot peppers.  When the receptors are activated enough by capsaicin, they can stop working – and so pain messages are interrupted in the body.

Capsaicin has been a common treatment for headache and migraine in the past.  Could it be that they work the same way – by blocking CGRP in the body?  If so, we may have more evidence than ever that these medications will work.

Expect to hear more and more about these meds as they get closer to market.  The promotion machine will go into full gear.  But remember, they are unlikely to work for everyone.  Our hope is that they will help a few people that haven’t been able to find help so far, or those who have found help but are dealing with side effects.  And maybe instead of weight gain (a common side effect in many migraine medications) they can enjoy some weight loss.

Meanwhile – pass the peppers.

For more:

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Child migraine research goes forward

by James on 14 July 2014

More good news about funding toward migraine research comes out of the UK.  £20 million is being put toward an initiative to focus on children’s medicine.  With migraine, as with many other diseases that children and adults get, the children tend to be an afterthought.  This worked for adults, let’s see if it works for kids too.  But this new initiative will focus on medicine specifically for children.  This will include medicine for children’s migraine.

Read more about this grant at the Royal Liverpool Children’s NHS Trust’s website.  One of the current projects going on involves Dr Steven Ryan, a consultant Pediatrition at Alder Hey Hospital.  His research involves children and questionnaires related to migraine.

Read more about child migraines here.

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Your girlfriends have given you lots of ideas about what to expect during pregnancy, including what to expect regarding headaches.  This will especially be true if headaches made a significant impact on your life before you were pregnant.

All this advice can be very useful.  But it can be dangerous if you don’t do two key things that you should be doing.

Pregnancy headache?
Specialists Kirsty Revell and Paul Morrish recently teamed up to look at the data regarding headaches and pregnancy.  Their findings were published in the journal The Obstetrician & Gynaecologist this spring (see “Headaches in pregnancy“).

First, and as expected, 90% of headaches experienced during pregnancy were from tension-type headache and migraine.  “Tension-type” headache, so called because we used to think it came from muscle tension (now we know it’s a more complex neurological headache), and migraine which may improve or get worse during the course of the pregnancy, though it tends to improve during the last trimester.

These headaches, though common, may be quite serious for a number of reasons.  Doctors are rethinking how we approach headache in pregnant patients.  There are good drug and non-drug options for pregnant women.

Some headaches can be more immediately dangerous for pregnant women, especially if not recognized and treated properly by a doctor.  For example, patients with cerebral venous thrombosis may have headache as their only symptom.  If the headache is ignored, the blood clot could lead to stroke, or even be fatal.

Neurological conditions, which often show themselves as various types of headache, are now the third most common cause of death in pregnant women.  And sometimes it takes a neurologist to properly diagnose and treat the issue.

So what are the two key things you must do in order to stay safe during pregnancy, when it comes to headache conditions?

First, pay attention to the symptoms you’re experiencing, especially when they’re related to headache.

The changes you experience during pregnancy may seem overwhelming, and it could be tempting to just say that it’s “normal” (after all, your friend said this would happen), or just a minor thing among the 289 other things you need to mention to your doctor.

But headache is not normal, and can be dangerous.  Especially if it changes or gets worse.  If you notice any unusual symptoms, or your headaches get worse, pay attention to what your body is telling you.  If possible, write down the details.

If you already have migraine, you may notice that the headaches improve, but you still experience visual aura, or that the aura changes.  Pay attention.

The second thing you need to do should be obvious – talk to your doctor.  She may simply tell you to keep an eye on the symptoms, or to take advantage of a treatment for the pain.  And that may be all you need.  But she also may refer you to a specialist for further testing.

It may seem like just another thing to worry about for such a “small” thing like a headache.  But the referral could save you serious problems in the future.

Watch for changes.  Talk to your doctor, even if the changes are small.  And if symptoms continue to worsen or have a major impact on your life, make sure your doctor is listening and finding you the treatment you need.

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You’ve had a little to drink – or maybe more than a little – and while you’re still having a good time, the headache strikes.  What’s happening?  Should you be concerned?

Alcohol Headache

Yes, you should be.  If you have a headache within two or three hours of drinking alcohol, you’re experiencing something different from the familiar “hangover”.  In fact, the International Headache Society has classified these as two different types of headache.

The headache that arrives early is known as an immediate alcohol-induced headache.  That doesn’t mean it happens right away, but if it happens within 2-3 hours, it qualifies.  This has sometimes been called the “cocktail headache”.

If these symptoms are new to you, you need to go to your doctor and explain your symptoms and medical history, in order to be sure something serious isn’t behind the headache.

Be sure you tell your doctor about any other headache conditions you have.  It could be that people with tension-type headache, or migraine attacks, may be more susceptible to this rare alcohol induced headache.  It could also be that the alcohol is triggering an attack.

If you have another headache condition, your best first step will be to treat (or continue to treat) that condition.  Getting migraine attacks under control, for example, should improve the situation.

Unfortunately, immediate alcohol-induced headache is notoriously changeable.  You may drink a little one day and get a headache, and drink a lot another day with no problem.  The only way to certainly avoid the headache is to avoid the alcohol.

Do keep a headache diary, paying special attention to any alcohol you’re drinking.  This will help your doctor diagnose you correctly and find a treatment plan which works for you.

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Do changes in temperature trigger periods of cluster attacks?  Researchers in Taiwan say yes, but the connection may not be as simple as you think.

Cluster headaches come in clusters.  After a period with no headaches, these short-term and incredibly painful sharp burning headaches come and go, lasting only a few minutes to three hours.  (For more on cluster, see this graphic)

Researchers are trying to get a better understanding of what exactly triggers cluster, and some of this research has focused on weather patterns.

In a study published in the journal Cephalalgia, the focus was on the temperature and the changes in seasons.

The study confirmed that autumn is the worst season for cluster patients.  The fewest attacks happen in winter, with spring and summer being in-between.

Interestingly, the transition from autumn to winter and from winter to spring were also common times for clusters of cluster headaches.

Researchers also found that certain changes in temperature tended to increase the likelihood of cluster attacks.  Higher temperatures were worse, but also changes in temperature following a warm period.  You can read more about their findings here:  Temperature variation and the incidence of cluster headache periods

Although a fairly large study, because it was done in Taiwan it could be that there are seasonal factors there that would be different in other parts of the world.  However, this isn’t the first time that autumn and early spring have been marked as a bad time for cluster patients.  And the further investigation into temperature may give us an idea about why certain times of year are worse for some.  The more we know, the better we can prepare for and treat these cluster periods.

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