How to Cope with Migraines? Modern Treatment Methods
Migraine is a disease that negatively impacts the daily functioning of those affected.It has a recurring nature, consisting of symptoms that precede a migraine attack, headaches accompanied by gastrointestinal and neurological symptoms. How many people struggle with this disease, what is its progression, and—most importantly—how can it be effectively treated?
How many people suffer from migraines?
Migraines occur two to three times more frequently in women than in men. Their frequency also varies by age group, with the highest prevalence among individuals aged 25–55 when most people are at their peak professional activity at 12%. Additionally, 14% of the population is at risk of developing migraines, which adds up to 26% of people either suffering from migraines or being at risk in the future. Chronic migraines, in contrast, affect 0.91% to 2.20% of the population.
According to the Polish Central Statistical Office’s 2021 census, Poland has a population of 38,179,800, 65% of whom are of working age. Based on this, it can be estimated that 2.75 million to 6.5 million people in Poland suffer from migraines (including probable migraines), with 230,000 to 550,000 affected by chronic migraines.
Migraine Symptoms
A typical migraine attack consists of four phases, although not all of these phases need to occur during an episode.
Prodromal Phase
Characterized by diverse symptoms:
- psychic
- neurological
- general
Aura
A set of neurological symptoms preceding the headache:
- Sensory
- Motor
- Cognitive
Headache
In 60% of cases, migraine pain is unilateral, pulsating, and severe. It worsens with physical activity or even simple head movement. It is often accompanied by gastrointestinal symptoms such as nausea and vomiting, which make taking medications difficult.
This pain typically lasts between 4 and 72 hours. However, individuals with chronic migraines may experience headaches on at least 15 days per month.
Postdromal Phase
This phase brings difficulty concentrating, fatigue, irritability, low mood, lack of energy, drowsiness, muscle pain, lack of appetite, or sudden hunger.
Consequences of Migraine Headaches
Frequent migraines are associated with low physical activity and increased susceptibility to stress. Additionally, migraines often coexist with conditions such as sleep disorders, depression, anxiety disorders, hypertension, and eating disorders, which can sometimes lead to obesity.
Chronic migraine sufferers are particularly challenging to treat, as 40% of them do not respond to traditional preventive treatments and often overuse painkillers.
Migraine Treatment
Modern research has led to effective treatments and prevention methods, focusing on understanding the mechanisms that trigger migraine attacks. Calcitonin gene-related peptide (CGRP) has been identified as a key neuropeptide in the trigeminovascular system, released during migraine attacks. It activates pain receptors, dilates blood vessels, and causes neurogenic inflammation.
Four monoclonal antibodies have been developed based on these mechanisms:
- Three targeting the CGRP peptide (eptinezumab, fremanezumab, and galcanezumab).
- One targeting the CGRP receptor (erenumab).
These antibodies are safe, well-tolerated, and effective, suitable for treating both episodic migraines and chronic migraines. Clinical studies have shown significant reductions in the number of migraine days, decreased use of painkillers, and improved quality of life compared to placebo. They also alleviate symptoms such as photophobia, sound sensitivity, nausea, and vomiting.
The most common side effects reported include injection site reactions such as pain or redness. Mild constipation was observed with erenumab. Long-term use of these antibodies continues to prove their safety and effectiveness. Treatment should last at least 6–12 months.
Author: Dr. Maria Maliszewska