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HeadWay, Issue #164 -- Answers: New Migraine & Cluster Meds, Histamine
April 16, 2018
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In this issue:

More Questions: Histamine and CGRP Inhibitors

Say what?! Refractory


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--Join Me!--

I'm releasing this edition of HeadWay a little earlier than usual, because I want to make sure you don't miss the Migraine World Summit, which begins on Wednesday. You can take in as little or as much as you want, because it's all online and the tickets are free. Pick them up today so you're ready: Migraine World Summit

For more information about why you should encourage your family and friends to get tickets, even if they're not able to watch most of the seminars, see Fight Migraine and Headache – Time to Fill Your Toolbox

See you there!

More Questions: Histamine and CGRP Inhibitors

Last month we were talking about diets, so I'm going to start off on the same topic, thanks to a message from Michael in Canada.

Michael wanted to let us know that his wife, who has migraine, has been helped by information about the link between histamine and migraine.

Essentially, it seems that some migraine patients have high levels of histamine, due to various factors. The main part of the treatment is diet - but a diet basically focused on avoiding foods high in histamine, or foods that may result in high histamine (such as fermented foods, citrus fruits, fish and food additives).

Rather than get into all the details, I will point you to these two articles:Holly from the USA was also wanting information about new CGRP inhibitors.

Information specifically on insurance questions is scarce until these drugs actually start rolling out. The basic consensus for the time being is that they will be expensive, even with insurance.

(I should also note that, due to commitments I have this year, I'm writing this a little further in advance than normal - so as of the time of writing...)

Right now, I'm especially watching these upcoming medications, which should roll out in the next few months:
  • Erenumab (also known as Aimovig or AMG 334): This one may be available within a few weeks in some parts of the world. Erenumab is designed to prevent migraine attacks.
  • Fremanezumab: This one is for chronic and episodic migraine, chronic and episodic cluster headache, and post-traumatic headache. This may be the one to watch first for cluster.
  • Galcanezumab: Again, for prevention of both migraine and cluster.
  • Eptinezumab: Also for chronic and episodic migraine. It may be a little behind the other three, but it's coming.
Each one of these will have its pros and cons. They will not instantly cure most migraine sufferers of the world, so be cautious about pinning too many immediate hopes on them. That being said, they are the vanguard of many new treatments that are being investigated that could significantly change the face of migraine treatment.

Incidentally, there is some interesting research regarding the relationship between histamine and CGRP. Both are related to pain, and may interact in some interesting ways. But I'll leave it there for now!

Say what?! Refractory

Sometimes we hear about "refractory" headache (or "refractory" migraine) - is that a new class of migraine? No, actually, "refractory" simply means stubborn. So any condition that is refractory, or treatment-refractory, is basically difficult to treat. For example, the medications that often work don't work for someone with refractory migraine (the same for refractory depression or refractory epilepsy, etc.)

This does not mean that you've tried "everything" and that "nothing" works. There is still more you can try. It just means that you may not be helped by a few of the more common treatments.

I'm pretty refractory myself - stubborn. I'm going to keep fighting migraine and headache disorders! What about you?

Thanks for reading!  Remember, if you have feedback or ideas for future issues, visit the HeadWay MailRoom.  Your password is nomoache.
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