Discovery: A Link Between Opioid Overuse Pain and Migraine Pain
Researchers at the University of Illinois have discovered a fascinating link between opioid overuse and migraine pain. This particular link is a good sign for new medications that are being studied now. Could these new medications help some migraine patients fight migraine and past opioid overuse at the same time?
Senior author Amynah Pradhan explains what the team was trying to find out:
“Endorphin is an example of a peptide that signals the brain to give a ‘runner’s high.’ However, not all peptides signal for pleasant outcomes. Pituitary adenylate cyclase-activating peptide, or PACAP, is a peptide that can induce migraines in migraine-prone individuals. Because the overuse of opioids can lead to worse migraines, we wanted to determine whether opioid-induced pain changed the amounts of peptides in the brain and understand if pain from migraines and opioid overuse shared any peptides in common.
Amynah Pradhan [source]
As you might guess, the link was found. In this study with mice, PACAP was high in models with migraine pain and models with opioid pain. This could help to explain why opioid use leads to “rebound headache” for migraine patients.
Of course this helps us further understand migraine and how it interacts with opioid use, which can be helpful in some cases but often ends up being harmful. But even more interesting is that medication for migraine is being developed right now which targets PACAP levels. We’ve talked before about two medications being developed, ALD1910, and AMG 301, which target these peptides. This from Alder Biopharmaceuticals:
Alder is developing ALD1910, a preclinical monoclonal antibody (mAb) designed to inhibit pituitary adenylate cyclase-activating polypeptide (PACAP) for migraine prevention. PACAP has emerged as an important signaling molecule in the pathophysiology of migraine and represents an attractive novel target for treating migraine. ALD1910 may hold potential as a migraine prevention treatment for those who have an inadequate response to other therapies and could provide another mechanism-specific therapeutic option for migraine patients and their physicians.
[source]
Could it be that these new medications would especially help patients who have been regular opioid users in the past?
For more, see this from ScienceDaily: A new link between migraines, opioid overuse may be key to treating pain