Are preventive CGRP blocker injections better for chronic migraine?

Question

Hello doctor,

I am 29, and have had migraine since college. Attacks occur three to four times a month, usually with one-sided throbbing headache, nausea, and light sensitivity. I take Sumatriptan; it works, but I feel drowsy after. Triggers include lack of sleep and red wine.

My mother also has migraines. I heard about monthly preventive injections like CGRP blockers. Are they better than daily tablets like Propranolol or Topiramate? I really want fewer attacks because it is affecting my work and social life.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

I hear how much these migraines are interfering with your daily life, and it is understandable that you are looking for better long‑term options. Since you are having several attacks a month that require Triptans and are affecting your work and social activities, preventive therapy is definitely worth considering. Here are my suggestions:

Traditional daily preventive medicines like Propranolol, Topiramate, or Amitriptyline can reduce attack frequency, but they often come with side effects and the need for strict daily use.
The newer CGRP (calcitonin gene-related peptide) monoclonal antibody injections, such as Erenumab, Fremanezumab, and Galcanezumab, are given monthly or quarterly, are generally well tolerated, and have been shown to significantly reduce migraine frequency in people who do not respond well to or cannot tolerate daily oral preventives.
They are usually considered when migraines remain frequent or disabling despite standard treatments, but availability and cost can be limiting factors. It would be wise to discuss both options with your neurologist.
Together, you can weigh the convenience and effectiveness of CGRP injections against the practicality and affordability of daily tablets to find the best approach for you.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.