CGRP and Migraines
The next-generation migraine drug blocks calcitonin gene-related peptide (CGRP). What is CGRP and why does it matter?
Ten things you should know about CGRP and migraines:
1. Seventy-five percent of patients reduced migraines by more than 50 percent with the next-generation migraine drug, ALD 403. ALD 403 uses antibodies to block CGRP.
Sixty-seven percent of the placebo group reduced migraines by more than 50% (injections have a high placebo effect) (Research link).
The new CGRP antibodies seem to be the most powerful migraine prevention drug, but nonbiased studies are needed to confirm these results.
3. CGRP antibodies for migraines will cost between $8,000 and $20,000 per year (news article).
Antibodies are produced by living cells and used as high-end treatments for cancer (study link).
4. CGRP is a peptide that is found throughout the body and may help regulate all major systems (e.g., respiratory, cardiovascular, intestinal, and immune) (study link).
However, the exact physiology of CGRP remains unclear.
It’s no surprise that blood pressure medication helps control migraines and pain medications can stop migraines.
6. Oxidative stress and inflammation release CGRP (study link).
High levels of oxidative stress are associated with migraines and nearly all migraine triggers.
Migraines may be a defense mechanism against the buildup of oxidative stress (full article).
7. The trigeminal nerve (around the face and head) releases CGRP during a migraine (study link).
CGRP will even trigger migraines when injected into patients (study link).
8. A drug developed in 2009 blocked CGRP receptors, but serious side effects—including liver toxicity—halted development of the medication (WebMD).
The new CGRP antibodies are expected to remove excessive CGRP, as opposed to blocking the receptors. Safer? Maybe.
9. CGRP antibodies may increase heart attack risk.
CGRP can prevent cardiovascular events by vasodilation (widening blood vessels).
Wiping out CGRP could turn a small blockade into a full-blown heart attack or stroke (study: “Wiping Out CGRP: Potential Cardiovascular Risks”).
The risk of developing cardiovascular events is 50% higher in women with migraines (study link).
New research shows that migraines may double the risk of stroke (WebMD).
Cardiovascular risks are a concern for migraine sufferers.
10. CGRP antibodies may increase depression in migraineurs. CGRP acts as an antidepressant when administered to the brains of mice before stress exposure (study link).
CGRP’s antidepressant activity is odd because CGRP levels in the cerebrospinal fluid of depressed patients are increased (study link).
Possible increased rates of depression are a concern for migraine sufferers.
Our understanding of CGRP is foggy at best. Raised levels of CGRP are associated with oxidative stress and heart disease (study link). But new research suggests that CGRP may help the body adapt to oxidative stress and cardiovascular disease (study link). CGRP has complex roles in locomotion (body movement) and the regulation of hot/cold, depression, and all of the body’s major systems (study link). Roles we don’t understand. It’s all new research.
Despite our limited understanding of the human body, we will produce drugs that have devastating consequences.
Just look at the war on cholesterol. Instead of fighting the oxidative stress associated with cardiovascular disease, we tried to attack cholesterol. It turns out that cholesterol levels don’t affect heart attack risk in large studies (article link). Statins do more harm than good, especially for migraine sufferers (news link). If we don’t understand cholesterol, what makes you think we’ll understand CGRP? By the way, cholesterol prevents migraines by stopping excitotoxicity and the release of CGRP (study 1, 2, 3).
When CGRP antibodies are on the market, humans will be the guinea pigs that test its long-term side effects. The FDA has almost no ability to uncover dangers of drugs once they are approved (NYTimes). At least that’s what top FDA officials claimed after the makers of the drug Vioxx hid high death rates from the FDA and killed more than 55,000 people from 1999 to 2004 (source 1, 2).
Understand the risk in taking a new medication. The new CGRP antibodies show spectacular success rates. Migraine is the number one neurological disability by a long shot (study link). Suicide rates for migraineurs are staggering. Some migraineurs will find that the risk of the new CGRP antibodies is worth the benefits.
CGRP antibodies are a temporary solution, though. CGRP is released from oxidative stress. Migraines are a defense mechanism against the toxic buildup of oxidative stress. Attacking CGRP will not address the root cause of migraines. It’s critical to learn more about how to eliminate oxidative stress and migraines (article link).
Read part two: Twelve natural ways to reduce CGRP and Migraines