Migraine: the CGRP revolution
Preventive antibodies and gepants change the game
Dr. Antoine Mercier
Neurologist
A disabling neurological disease
Migraine affects 12% of adults, mostly women. Throbbing unilateral headache, nausea, photophobia, phonophobia, sometimes preceded by aura. Major impact on quality of life.
Acute treatments
NSAIDs, triptans, gepants (rimegepant, ubrogepant), lasmiditan. Avoid medication overuse (>10-15 days/month).
Prevention
- Beta-blockers, topiramate, amitriptyline (historical)
- Anti-CGRP antibodies (erenumab, fremanezumab, galcanezumab, eptinezumab): monthly/quarterly injection, very well tolerated
- Atogepant, rimegepant oral for prevention
- Botulinum toxin for chronic migraine
Lifestyle
Regular sleep, hydration, identify triggers (food, hormones, stress), CBT, mindfulness.
Also read
Neurology
Migraine: Understanding and Managing Attacks
Migraines affect about 12% of adults. Identifying triggers and using the right treatment shortens crises.
Neurology
Epilepsy: Living With the Disorder
About 1% of the population has epilepsy. Two thirds achieve seizure freedom with appropriate medication.
Neurology
Alzheimer's Disease: Recognising Early Signs
Early detection enables better planning and access to therapies that may slow decline.