- A recent study suggests that GLP-1 drugs, like Ozempic, may make people with chronic migraine less likely to require emergency care.
- People using GLP-1s may be less likely to need new preventive migraine medications.
- The study does not prove that GLP-1s lower emergency care needs for people with chronic migraine, but it shows an association.
- More research is needed to determine how GLP-1s could help in the future of migraine management.
Migraine is a common condition both worldwide and throughout the United States. It may affect females more than males, but anyone can experience migraine.
This condition affects 37 million people in the United States. It is the third most common disease in the world and one of the 10 most disabling conditions.
Of those who experience migraine, 2% experience chronic migraine. Migraine is considered chronic when a person experiences 15 or more days per month with a headache for more than 3 months. Of these, at least 8 days per month have other features of migraine, such as aura, nausea, and heightened sensitivity to light and sound.
A recent preliminary study by researchers in Brazil and the United States suggests that GLP-1 medications for weight loss, such as Ozempic and Wegovy, may reduce the need for emergency care among people with chronic migraine compared with those who are treated with topiramate for migraine prevention.
“People with chronic migraine often end up in the emergency room, or they need to try several preventive medications before finding one that can work for them,” study author Vitoria Acar, MD, of the University of Sao Paulo, Brazil, and one of the study authors, said in a press release.
“Seeing these patterns of lower use of emergency care and lower use of drugs to stop migraines or trying additional drugs to prevent migraines among people taking GLP-1 drugs for other conditions suggests that these therapies may help stabilize the disease burden in ways that we haven’t fully appreciated yet,” Acar said.
For this study, the researchers analyzed data from a health record database of people with chronic migraine based on medical records.
They compared people who had begun taking a GLP-1 medication for other reasons, like weight loss, within a year of receiving a diagnosis of chronic migraine to individuals who started taking topiramate during the same period.
Each group consisted of around 11,000 people. The two groups were matched for factors such as:
The GLP-1 medications included in the study were:
The researchers found that 23.7% of people using GLP-1 drugs visited the emergency room in the following year. This is compared to 26.4% of those using topiramate.
Overall, they found that individuals using GLP-1s were 10% less likely to visit the emergency room, 14% less likely to be hospitalized, and around 13% less likely to need a nerve block procedure or receive a triptan prescription than those taking topiramate.
“The mechanisms are not yet fully understood in humans, but preclinical studies point to several overlapping pathways,” said Hsiangkuo (Scott) Yuan, MD, associate professor at Thomas Jefferson University, clinical research director at Jefferson Headache Center, and one of the study authors.
“These include anti-inflammatory effects within the trigeminal pain system, reduction of intracranial pressure through decreased CSF [cerebrospinal fluid] secretion, and modulation of CGRP [calcitonin gene-related peptide] (a key migraine-promoting signaling molecule),” Yuan said.
“Weight loss itself, regardless of how it is achieved, has also been associated with migraine improvement in patients with obesity, as supported by recent meta-analyses, though high quality RCT evidence remains limited,” he told Healthline.
The researchers also found that the group that was using GLP-1s was less likely to need new preventive migraine medications.
When compared to those taking topiramate, GLP-1 users were:
However, there was no significant difference between the two groups, and the need to begin taking beta-blockers.
Yuan noted that it is important to remember that this was observational data: it shows an association, not causation.
“We cannot yet conclude that GLP‑1 RAs treat migraine, and patients should not seek these medications specifically for that purpose outside of a clinical trial or established indication,” he said.
“It is also worth noting that our comparison with topiramate, which shares a weight loss property, may partly reflect topiramate’s poor real-world tolerability and compliance rather than a true pharmacological advantage of GLP‑1 RAs.”
However, he also stated that the overall signal is encouraging and justifies further investigation.
Medhat Mikhael, MD, pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the study, agreed.
“I believe it is a good start, but it is far too early to consider it as an agent or drug to use for [the] prevention of migraine. We need several large-scale trials to assess safety, particularly in young and middle-aged women, [who] constitute the majority of the population with migraine.”
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“Managing migraine nowadays has been very advanced, and it depends on the cause and frequency of the migraine,” said Mikhael.
Some quick steps to ease symptoms include:
- rest or nap in a quiet, dark room
- place an ice pack or cool cloth on your forehead
- drink plenty of fluids, especially if the migraine causes vomiting
Short-term treatments include:
- triptan drugs
- CGRP drugs
- over-the-counter medications, such as ibuprofen, aspirin, or acetaminophen
- nausea relief medications
Preventive medications include:
If you experience migraine, speak with your healthcare professional to decide what care plan is best for you.
