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HeadWay, Issue #172 -- How to Inoculate Yourself Against the CGRP Craze
January 21, 2019

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In this issue:

How to Inoculate Yourself Against the CGRP Craze

Recently at Headache and Migraine News...

Say what?! Peptides

How to Inoculate Yourself
Against the CGRP Craze

If you've been completely avoiding the world of migraine news over the past few years, it's possible that you may not have heard about "CGRP medications" (to use better terminology, anti CGRP, antibodies against CGRP).

But for those of us more submersed in the news, we're been flooded with phrases such as:
  • "A new era"
  • "groundbreaking"
  • "a new frontier"
  • "the first effective drugs in preventing migraine"
  • "Is there finally a cure for migraine?"
Here's the trick - the first three phrases on the list are actually accurate. But although some patients will find major improvement with these medications, the evidence so far shows that many will not. And so although some articles have been pretty fair, others have bordered on ridiculous.

Let's quickly clarify four things about these new medications (more about anti- CGRP meds in 2019). Then I'll suggest some responses.
  1. They are not a cure-all. Simply looking at the clinical trials should clear this one up for you. Whatever your co-worker or aunt tells you, this medication is not guaranteed to cure all your symptoms.
  2. These medications are groundbreaking. They are a new type of medication, which may help people that have not been able to find help before.
  3. In the next few years, expect to see other "groundbreaking" medications hitting the market, completely different from anti-CGRP meds. These are not the last story in migraine treatment.
  4. Long term testing has not been done. Many are already pointing out that we don't know how the body will respond to taking this medication over several years.
Now, I'll let you in on a little secret. Positive "buzz" is not just a marketing ploy (although, of course, it is that). A positive impression of a medication will actually make results better.

If your doctor has ever said to you,"You should start to feel better within an hour", she or he was not being naive. It was part of the treatment plan. Medications simply work better if we think they will.

So how can you take advantage of new medications without being completely depressed if they don't work? Here are some ways you can inoculate yourself against the CGRP craze (yes, one more list).
  1. See a doctor who knows your medical/family history (if possible, a headache specialist). The headlines are speaking to large crowds - you are an individual. There may be some meds that will work better for you, and only someone who knows your medical history can help you navigate the options.
  2. Be prepared to take a preventative medication for at least three months. A recent study on Emgality (galcanezumab), for example, showed that many patients who showed limited improvement in the first month or two actually improved in the third month (even some patients who felt that their symptoms were worse in the first month improved!).
  3. Be prepared to try more than one anti-CGRP medication. As with other preventatives and abortives, even a different type of the same class of drugs may work for you when another doesn't.
  4. Be optimistic. It's ok to be optimistic, and hope that a drug works, as long as you're also realistic. These drugs are a huge help for many.
  5. Be realistic. These meds may help you, or help you temporarily, or not at all. But there are other options. There is no reason to think that this is your last hope.

Recently at Headache and Migraine News...

Thanks for reading, commenting, and sharing! Here are a few recent articles you won't want to miss:

Say what?! Peptides

CGRP stands for calcitonin gene-related peptide. So - what is a peptide? A peptide is an important part of the cell, carrying various functions. It's actually similar to a protein (both are made of amino acid chains), but smaller.

That sounds very un-specific, and it is. CGRP, a neuropeptide, has many functions. It seems to play a large role in cardiovascular functions, and also pain messaging.

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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