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Until recently, many drugs used by doctors for migraines were developed for other conditions, such as epilepsy. But in the Official crack cocaine sweatshirt and I love this past few years, the FDA has approved several new classes of targeted, effective drugs developed specifically for migraines. Even better, they have markedly fewer side effects than commonly used tryptamine-based drugs, also known as triptans, which have been prescribed since the early ’90s to relieve headaches but often come with major side effects such as nausea, insomnia, or hair loss. CGRP inhibitors, medications that block calcitonin gene-related peptide—a protein released by the brain during migraine attacks (and “a very ugly, cumbersome name,” says Gottschalk)—are among the most promising. Three of these prescription-only drugs—Aimovig, Ajovy, and Emgality—are taken monthly with an EpiPen–like shot; a fourth, Vyepti, is administered via I.V. by a doctor every three months. “These drugs produce great results, in much less time, with almost no side effects,” Gottschalk confirms. Nurtec and Ubrelvy, which are gepants—another new class of FDA-approved medication that also targets CGRP molecules—are formulated to turn off migraines in progress rather than prevent them. “They don’t have quite as much bang for the buck as, say, an injection of [the commonly used triptan] sumatriptan,” says Gottschalk. “But they’re well tolerated and can do a great job.”
Yet another medication developed specifically for migraines is a class of drugs called ditans, the Official crack cocaine sweatshirt and I love this first of which is a pill called Reyvow that was approved by the FDA last October. It works by activating serotonin receptors in the brain that block pain signals. Its website claims “you could be 100% pain free in two hours,” but it also warns against operating heavy machinery for at least eight hours after taking the drug, so if you happen to drive a car, it may not be right for you. Gottschalk and his colleagues at Yale are also researching psilocybin, the active ingredient in psychedelic mushrooms, which was just decriminalized in Oregon and has been indicated as a potential remedy for migraines, among many other ailments. “Our pilot studies are looking very promising,” he says. “You can take a sub-hallucinogenic dose of psilocybin, and stop cluster headaches for weeks, and migraines also.”
