Thinking Outside the Box: Innovative Treatments for Migraines and Chronic Headaches

If you’ve experienced a migraine, you know how debilitating it can be; persistent nausea and vomiting, ultra-sensitivity to light, auras that mess with your vision and balance, changes in your moods and even auditory hallucinations. Now imagine if you experienced those symptoms multiple days throughout a month’s time!

Unfortunately, many treatment options aim to reduce certain symptoms rather than address the root of the condition, but innovative new treatments on the horizon show promise and relief for migraine and chronic headache sufferers alike.

Hamid Kadiwala, M.D., a neurologist and physician on the medical staff at Texas Health Fort Worth, says treatment options have come a long way even in just the past few years.

“The search for new treatments in headache medicine is an active on-going process,” he says. “There is constant experimentation regarding the ‘off-label’ use of different classes of medication for headaches.”

Migraines are classified as an episodic disorder, meaning they happen habitually and often occur on one side of the head. Symptoms include visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraine attacks can last between four and 72 hours.

A typical occurrence can be a chronic daily headache, chronic migraine or chronic tension headache, and occurs more than 15 days per month. Symptoms vary depending on the type of headache, but the intensity tends to ebb and flow throughout the episode.

Although the two differ, Kadiwala says the treatment is similar for both migraines and chronic headache.

“The first medication is known as a preventative which the individual takes daily regardless if they have a headache or not,” Kadiwala explains. “The goal of this medication is to reduce the number of headache days a month. The second medication is an abortive and is meant to break a headache at its onset.”

In the past, Kadiwala notes that there was no medication specifically made for the prevention of migraines, but physicians would commonly prescribe anti-depressants, anti-seizure medications, anti-hypertensives, and anti-dementia medications for their effectiveness at preventing or reducing symptoms of a migraine.

But recently, a new classification of medication called erenumab has been used to target and block receptors in the brain that specifically cause migraines. The FDA-approved medication is given once a month by self-injection.

According to the Federal Drug Administration, the effectiveness of the medication was evaluated in three clinical trials. In the first trial, patients experienced, on average, one to two fewer monthly migraine days than those on the placebo. The second trial lessened migraine days per month by one day versus those on placebo, while the third trial lessened migraine days per month by two and a half days versus those on placebo. The most common side effects reported were injection site reactions and constipation.

As erenumab finds its footing among medical professionals, Kadiwala says more traditional treatments include neuromodulators that stimulate the vagal nerve, Botox and even acupuncture. If you prefer to go a more natural route, Kadiwala says herbs such as Butterbur and Feverfew have been shown to help lessen symptoms.

While new treatments are being explored, Kadiwala says one way individuals can try to prevent a migraine or a headache is to learn what possibly triggers an attack.

“Headaches do not exist in isolation of the environment. This requires thinking outside of the box somewhat,” he explains. “For example, stress, which is a big trigger, could be addressed with psychology. One’s eyes should be checked, and sleep apnea should also be explored. And for a select few patients, an electroencephalogram can be obtained to rule out seizures.”

For those who suffer from migraines or a chronic headache, the pain and additional symptoms can be crippling, with many unable to perform daily tasks during an attack, but Kadiwala says the future looks bright for advanced treatment options.

“I can sympathize that the word ‘headache’ does not accurately describe what a migraine is.  People who do not have them often do not understand what a debilitating disease this can be,” he adds. “I would advise anyone who has tried multiple medications without efficacy to remain hopeful. There are always new methods and medications that will be made available.”

To find a physician with Texas Health Resources who can help you manage your migraines or chronic headaches, visit TexasHealth.org/provider.

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