I have migraines. Will CGRP inhibitors help me?

Question

Hello doctor,

I am 29 and have had migraines for years, but recently they have become more frequent, almost 10 days a month. MRI brain was normal, and I am on Propranolol 40 mg daily for prevention.

Still, the attacks come with light sensitivity and nausea. I have a few questions, such as:

Could hormonal changes be worsening my headaches?
Would switching to newer injectables like CGRP inhibitors help reduce frequency more effectively?
Also, is it safe to take Triptans so often for relief, or can that cause rebound headaches?
My vitamin D is 19 ng/mL; can deficiency contribute to more severe or frequent migraine episodes, and should I take supplements daily?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I hope you are doing well. There are multiple triggers for migraines, and everyone has their own set of triggers. One has to identify them and try to avoid them. Hormonal changes can definitely contribute to it, and usually, around the menstrual cycle, it can get worse.

You can try increasing Propranolol to 60 mg a day (30 mg in the morning and 30 mg at night).

Alternatively, if you do not have a history of kidney stones, you can switch from Propranolol to tablet Topiramate 25 mg once daily for two weeks and then continue twice daily.

Also, for nausea, you can take a tablet of Prochlorperazine 10 mg at the onset of headache. If you need to use Triptans for more than 10 days a month, that can lead to medication overuse headache.

Please keep in mind that you may need to switch between drug classes before finally finding one that works for you.

As for vitamin D, you need to replace it. If you find daily therapy hard, you can try taking 200,000 international units once a month for three months and then once every three months.

I hope it helps.

For more queries, feel free to reach out to me anytime.

Thank you.