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Finding the Right Chronic Migraine Treatment

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3 Benefits of Injectable Medications for Chronic Migraine

Medically Reviewed By Susan W. Lee, DO

Injections can be a safe, convenient, and effective way to treat recurring migraine headaches.

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If you have chronic migraine, you may often need acute migraine medications to treat symptoms and preventive medications. Preventive treatments may help reduce migraine episode frequency and severity.

When people start migraine prevention therapy, healthcare professionals typically prescribe oral medications, such as beta-blockers or certain antiseizure drugs.

However, several approved injectable medications are available as preventive treatments. These injectable medications may have some distinct benefits, which can help provide relief from chronic migraine.

1. Injectable medications may be effective for chronic migraine when oral treatments don’t work

Chronic migraine injections target migraine pain differently than traditional oral medications. The injections may be helpful for people who find that standard preventive medications don’t work for them.

Experts developed a class of medications known as calcitonin gene-related peptide (CGRP) monoclonal antibodies specifically to treat and prevent chronic migraine. CGRP is a protein in your body that plays a role in migraine development. CGRP monoclonal antibodies block CGRP activity.

CGRP inhibitors include:

  • erenumab (Aimovig)
  • galcanezumab (Emgality)
  • fremanezumab (Ajovy)
  • eptinezumab (Vyepti)

Experts also prescribe onabotulinumtoxin A Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , commonly known as Botox injections, for migraine prevention. Many believe that Botox injections block the release of chemicals that help transmit pain signals to your brain. According to the American Migraine Foundation, Botox can reduce headache days by 50% after two treatments.

2. You can take injectable migraine medications less frequently

Usually, you may take oral preventive medications Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source each day or space out migraine injections at much longer intervals. Injections may be more convenient for people who want long-term treatment instead of daily medication.

Of the CGRP monoclonal antibodies, Aimovig and Emgality are self-injectable once per month, and Ajovy is self-injectable monthly or quarterly. A healthcare professional can give you Vyepti as an infusion into your vein once every 3 months. They can also give you Botox injections approximately every 3 months.

3. Injectable migraine medications may be safe and well tolerated

Experts rigorously studied Botox and CGRP monoclonal antibodies Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source in clinical trials for chronic migraine treatment. The studies found that both types of medication may have:

  • good safety profiles
  • few interactions with other drugs
  • generally mild side effects, such as pain at the injection site
  • links to an improved quality of life in terms of overall well-being and participation in daily activities

Persistence, meaning how long people continue to take a medication after receiving prescriptions for them, may often be a concern with preventive migraine treatments.

However, studies show that people may be more likely to continue taking injectable migraine treatments than to continue taking oral medications. This shows that the injections may be effective and well tolerated.

Takeaway

If you receive a diagnosis of chronic migraine, talk with your doctor about your treatment options. Injectable medications may be worth exploring if your treatment plan doesn’t work for you. Injections may not suit everyone, so your doctor can help determine whether they’re right for you.

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  1. Blumenfeld AM, et al. (2022). Effectiveness and safety of chronic migraine preventive treatments: A systematic literature review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845441/
  2. Botox for migraine. (2017). https://americanmigrainefoundation.org/resource-library/botox-for-migraine/
  3. Guerzoni S, et al. (2017). Long-term treatment benefits and prolonged efficacy onabotulinumtoxinA in patients affected by chronic migraine and medication overuse headache over 3 years of therapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676047/
  4. Muddam MR, et al. (2023). Efficacy and safety of anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies in preventing migraines: A systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586710/
  5. Siddiqui M, et al. (2021). Comparing the efficacy, safety, and superiority of calcitonin gene-related peptide monoclonal antibodies and Botox in preventing and treating migraines. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847775/
  6. Tzankova V, et al. (2023). Pharmacologic prevention of migraine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904820/
  7. Varnado OJ, et al. (2022). Treatment patterns for calcitonin gene-related peptide monoclonal antibodies including galcanezumab versus conventional preventive treatments for migraine: A retrospective US claims study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8976490/
  8. What is chronic migraine? (2021). https://americanmigrainefoundation.org/resource-library/what-is-chronic-migraine/

Medical Reviewer: Susan W. Lee, DO
Last Review Date: 2024 Feb 7
View All Finding the Right Chronic Migraine Treatment Articles
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