Robbins Headache Clinic Archives - Headache and Migraine News

7 September 2020

CGRP Medication Side Effects – “I hadn’t thought of that…”

James Discoveries & Stats, Medications 0

One of the things patients like about CGRP related migraine medications is that the side effects are often less than with other drugs. But there can be side effects.

Calendar clock — Side effects – mostly temporary…?

A recent study used a checklist to see if patients would notice other side effects that weren’t so obvious, or that they might not think of right away. The researchers were concerned that some of these were missed in some of the original trials.

This particular study was presented at the 62nd Annual Scientific Meeting of the American Headache Society, and came from the Chicago Medical School and Robbins Headache Clinic. 119 chronic migraine patients were first asked about side effects generally, and then they were handed a checklist.

The study itself is arguing for the use of checklists to identify side effects, but for us it is interesting to see which adverse effects were noticed using the checklist.

These patients had been on therapy for two months. What about you? If you’ve taken a CGRP related drug, have you noticed any of these? Here are the most commonly reported ones:

Constipation
Anxiety
Injection site reaction/irritation
Insomnia
Hair Loss
Muscle Pain/Cramps
Joint Pain
Irritability
Increased Headache
Depression
Nausea

Again, remember that generally speaking side effects from these medications have been mild. Some also go away with time. For example, many patients experience increased headache for a few days or a couple of weeks, but then start to feel better. Weight gain lasted from 1-4 months. Of course injection site reactions were usually very brief.

However, some symptoms could be ongoing, so do check with your doctor. Hair loss, constipation, and sexual dysfunction, for example, seem to last longer (but again, many people have no problems whatsoever).

What’s been your experience?

(Study abstract here (scroll down): CGRP Monoclonal Adverse Effects: Evaluation Via Use of a Checklist

27 April 2020

CGRP Drugs and Weight Gain

James Information, Medications, Tips 3

Do CGRP injections cause weight gain? If so, what can I do about it?

This is a (somewhat belated) response to a question from Char in the United States. If you have a question, use the button on the right to fill in the form.

Char was specifically asking if there is a CGRP injection that doesn’t cause weight gain.

One of the concerns that doctors have had regarding the new CGRP medications is that they are – well, new! Of course, every medication has to be new at some point. But what that means is that long term testing is really only starting. (For some of the concerns expressed early on, check out At Stake: The Possible Long-Term Side Effects of CGRP Antagonists. Weight change is one of the questions that is highlighted.)

So at this moment in history, we are waiting for long term trials, and also watching carefully clinical experience – that means your experienced with the drugs.

Many people are being helped by the new medications, but there are reports of weight change – not just weight gain, but weight loss. The Robbins Headache Clinic reported on some of the early experiences they had with the CGRP medications. Here’s what they’ve written about weight changes:

Bloating & Weight Changes: weight gain can be a problem, and if significant enough we stop the medication. This does not appear to be as much a problem as with other medications such as Lyrica, Depakote, gabapentin and the tricyclic anti-depressants, but we are seeing it. This could be because our feeding and hunger is centered in the hypothalamus which is not protected by the blood-brain barrier. A few people have lost weight, and if it is significant then we stop the medication.
CGRP QUESTIONS/ANSWERS

So in short, they saw both weight gain and weight loss. However – and this is important – CGRP related medications don’t seem to be the worst offenders when it comes to weight gain.

The Pain News Network also reported on a survey of those using the new medications. According to the survey, 12% of patients reported some weight gain (see New Migraine Prevention Drugs Making Inroads).

We have to remember that these are not controlled studies. And so we come to a very important question – are these drugs directly causing weight gain?

Here’s a simple example. If you are constantly nauseous, and a CGRP injection significantly improves your health, what just might happen? You might eat more.

This is the argument that Drugs.com makes for Aimovig. “Does Aimovig cause weight gain or loss?” – no, but changing migraine symptoms may. You may think that their answer is a little overconfident, but the fact remains that there may very well be a complex set of reasons why you gain or lose weight on a CGRP drug.

So back to Char’s concern – what to do?

First, be sure you are communicating your concerns with your doctor. This is a case when customized medical help is very important. Your doctor can help you find the best solutions for you.

Second, and this will help your doctor, be sure to keep a detailed diary of your symptoms and any changes that you notice.

Third, try another CGRP medication. Unfortunately, we simply do not know enough at this point to give you a list of CGRP related medications that are least likely to cause weight gain for you. Like many classes of drugs, it can make a significant difference if you try another drug of the same class.

And, of course, as your symptoms (hopefully!) lessen, take the time to learn and re-learn some basic healthy habits.

We would love to hear your experiences and suggestions – leave a comment! 🙂