It starts with flashes of sunshine. Zig-zag lines float across your vision. You’re feeling a slight tingling in your cheeks and limbs. Then comes a stabbing headache so intense you forget every part—what you were doing, where you’re, and methods to compose yourself.
Scientists still don’t fully understand why migraines occur. Unlike dull headaches during a chilly or pulsing headaches after an evening of overindulgence, migraines are debilitating and strike at seemingly random times. Stress, lack of sleep, and vivid lights could spark an attack—however the triggers vary between people, making them hard to predict.
Despite many years of research, few medications can be found. But a surprising newcomer may change the sector. Called liraglutide, the drug is in the identical family because the blockbuster weight-loss drugs Ozempic and Wegovy, which have taken the world by storm.
In a small trial of 31 individuals with chronic migraines who didn’t reply to other treatments, liraglutide slashed the variety of days they experienced migraines by over half. The drug worked remarkably fast, with most participants feeling relief inside the first week.
Although the volunteers were obese—which increases the possibility of migraines—subsequent evaluation showed the drug lowered migraines even with minimal weight reduction.
“Liraglutide may operate via different mechanisms [than weight loss], and represent a promising latest approach to migraine prevention,” wrote the team.
Headache on Headache
Migraine has been a headache to review for many years. Even though it affects nearly 15 percent of individuals worldwide, its origins within the brain remain mostly mysterious. The condition isn’t only a severe headache—people also experience nausea, dizziness, and sensitivity to light, sound, and smell.
Scientists originally thought migraines occurred due to blood vessel problems within the brain and treated the headaches with standard pain medications. But these don’t work well. Recent studies paint a way more complex picture of the condition. Migraines appear to stem from dysfunctional neural networks in certain brain regions, where neurons release messengers called neuropeptides that spark inflammation and dilate blood vessels within the brain.
These chemicals potentially increase intracranial pressure—that’s, the brain pressing against the skull—and will act as a trigger for migraines.
Scientists investigating neuropeptides have already designed a migraine treatment. Called anti-CGRP drugs, these medications might be injected into the bloodstream to treat or prevent chronic migraine attacks. One controlled clinical study in 667 patients found that those that received injections experienced fewer days of head-splitting pain.
Although these drugs are effective and have relatively mild unintended effects, they’re expensive. This motivated the team to look for an additional approach to lower brain pressure.
Chemical Polymath
Enter GLP-1 agonists. Most famously represented by Ozempic, these drugs skyrocketed to fame for his or her ability to slash weight, manage diabetes, and lower the chance of heart disease.
That’s not all they will do. The drugs goal proteins called GLP-1 receptors, that are dotted on the surfaces of multiple cell types, including neurons, suggesting that beyond managing weight, they might regulate the brain too. One study found that every day injections of a GLP-1 drug slowed cognitive decline in individuals with mild Alzheimer’s disease. One other trial suggested the drugs could tackle alcohol addiction. How they work remains to be under investigation, but these clinical trials suggest GLP-1 drugs can impact the brain through chemical signaling, or perhaps pressure.
Previous studies found the drugs tinker with the quantity of fluid within the brain. The organ is bathed in a nutritious soup called cerebrospinal fluid, which cushions it and removes waste. However the fluid can construct up and increase intracranial pressure—potentially resulting in migraines.
GLP-1 drugs might lower that pressure. An early study found a drug normalized dangerously high brain pressure in rats, like deflating an overblown balloon. A small randomized clinical trial in individuals with high intracranial pressure found the drug nearly restored it to normal.
These promising results led Simone Braca on the University of Naples Federico II and colleagues to check liraglutide, a GLP-1 drug, as a treatment for chronic migraine. All 31 participants within the study were roughly middle-aged, obese, and had already tried at the very least two other drugs with none improvement of their symptoms.
“Obesity can worsen migraine by increasing headache frequency and reducing response to straightforward preventive treatments,” wrote the team.
Each participant received a every day injection of the drug for 12 weeks. Additionally they kept a “headache diary” to trace their migraines and log any potential unintended effects.
Almost everyone reported fewer days with migraines. On average, their headaches dropped from 20 days a month to roughly 11 days. Some people reported that the times that they had headaches fell by roughly 75 percent. One participant remained completely migraine-free after the primary injection and for the remaining of the test period. Others weren’t so lucky: 4 people didn’t reply to the treatment, suggesting it’s not a universal cure-all.
Those that benefited, nevertheless, said the drug improved their quality of life in only every week, despite minor unintended effects. Roughly 40 percent of participants experienced nausea or constipation, each of that are common unintended effects for those taking GLP-1 drugs. The symptoms eventually went away.
As expected, the participants dropped a couple of kilos, but additional statistical evaluation found the burden loss didn’t contribute to migraine frequency. This means the effect of GLP-1 drugs on migraine “is independent of their weight reduction effect,” wrote the authors.
On the Starting
The team is just beginning to untangle how GLP-1 drugs fight migraines. Because they lower intracranial pressure, the shots might reduce the quantity of the neuropeptide CGRP pumped out within the brain. Existing anti-CGRP migraine drugs lower inflammation and reduce intracranial pressure, and liraglutide might need similar effects.
GLP-1 drugs also can play with salt and potassium levels within the brain, which controls how neurons activate. Tinkering with these levels could potentially alter a neuron’s ability to fireplace, changing the brain’s capability to release CGRP and other neuropeptides.
Also, the study has limitations price noting. Each participant knew they were receiving the drug, so placebo effects can have clouded their judgement. Although they experienced advantages for 12 weeks, an extended follow-up period could higher gauge if the advantages last. And since the trial only recruited individuals with obesity, the outcomes may not generalize to a broader population.
The team is already planning a big randomized controlled trial. “As an exploratory pilot study, these findings provide a foundation for larger-scale trials” that examine the role GLP-1 drugs may play in migraine management, wrote the authors.