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HeadWay Issue #232 - Precision Customized Migraine Treatment
October 21, 2024
Hi!

In this issue:

Precision Customized Migraine Treatment

*An Update from James


Precision Customized Migraine Treatment

As you may know, there are many different kinds of migraine. You know this because you've done your research. But - how much does it really matter? Is it possible to "customize" your migraine treatment for your specific migraine type?

The answer is: Yes and No. For years I've encouraged people to understand what type of migraine or headache they are dealing with, and to talk about it with their doctor. I believe it is important for your doctor to know your specific symptoms.

Still, many doctors simply prescribe for "migraine" - or, for "headache" in general, without realizing that different types may require different treatments.

That being said, we still know very little about how to truly customize treatment. We do know a little about certain medications (e.g. Drug "A" works best when patient has "B" symptoms). And as I've written about various treatments, I've tried to note those connections.

But it will be more important for us to learn more about how migraine works, and how the medications work. Most people would be surprised to know how often researchers say,"This seems to work ... sometimes ... no idea why!"

Recently, an international team of researchers looked into this issue and published a report in the journal Cephalalgia. Using their research, and the experience of the last twenty years, let's look at two things. First, what are some examples of treatments that may work well in certain cases? Second, what can you do to make sure you're getting the best "customized" treatment for you?


Examples of "Customized" Treatments

Some of the examples were negative (e.g. you won't respond well to this drug if you have this symptom). Also, the report looked not only at symptoms, but also genetic factors, proteomics (proteins in the body), brain imaging information, and other physical factors.

But here are some examples of the more evident connections:
  • Migraine in an older person? Try triptans, erenumab, or fremanezumab.
  • Dealing with past medication overuse symptoms? Try Botox or galcanezumab.
  • Have paresthesia (a sensation of numbness, pins and needles, etc)? You might want to put topiramate higher on the list.

What can I do now?

There are some things that you can do now to make sure you are getting the best treatment possible:
  1. Learn more about the many types of headaches
  2. Be sure that your doctor knows about other symptoms and conditions that you have. This is very important, because some treatments may help with more than one thing at a time, or may help one symptom but cause problems in other ways.
  3. Know your personal and family medical history. Have it handy to share with your doctor.
  4. Consider a headache specialist. This will probably be a neurologist who has experience treating migraine. This can be a short-cut to a better treatment.
  5. This is a matter of trying the better treatments first. You are not out of options. If your doctor is "giving up", find a specialist.
  6. Spend some time browsing at Headache and Migraine News. Research treatments and medications you're looking at. Don't limit yourself to drugs, by the way.

*An Update from James

HeadWay is back, after some time off! But on a personal note, life is still pretty unsettled for various personal reasons. So I will email and post as I'm able. Thanks for reading! The research continues, and the fight against migraine is still on!



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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