The drug liraglutide, used to treat type 2 diabetes and obesity, halved the incidence of treatment-resistant migraines in participants in a small clinical trial. Until now, such drugs that affect appetite and metabolism were not thought to be able to affect the processes in the brain that cause migraines.
The effectiveness of liraglutide and other similar drugs will be tested in larger studies and the mechanism of their effect on migraine will be studied. Research published in Headache: The Journal of Head and Face Pain.
The study involved 31 obese people who also suffered from chronic or frequent migraines that were not responding to at least two other medications. They were given liraglutide for 12 weeks, after which their migraine frequency was compared to before treatment. It was found that liraglutide reduced the number of days people had migraines from 19,8 days per month to 10,7 days. However, the patients' body mass index did not decrease significantly, suggesting that the reduction in migraine frequency was not due to weight loss.
The researchers did not perform additional tests, such as cerebrospinal fluid analysis or brain activity measurements before and after treatment, so they could not determine the cause of the reduction in migraine frequency. However, previous studies have shown that drugs similar to liraglutide reduce intracranial pressure, which may reduce the release of CGRP, a peptide that is associated with migraine headaches. Another possible mechanism of action of the drugs is through their effects on glucose metabolism, which has also been linked to migraine.
The study has two major limitations: the small sample size and the lack of a placebo control group, so its results will need to be validated before such a treatment can be implemented in practice. However, the lack of significant side effects, the effect on treatment-resistant migraine, and the use of a drug with a novel mechanism of action make this approach useful for patients whose migraines are associated with excess weight.
