Migraine drug that treats headache also eases symptoms like dizziness

A drug called ubrogepant, which is already used to treat migraines, has now been found to reduce the non-headache symptoms that often hit in the hours preceding a migraine itself – making it the first drug that is known to work on these early symptoms.

Before the debilitating headache of a migraine hits, many people experience a prodrome phase where they get warning signs, such as sensitivity to light or sound, dizziness and neck stiffness, which can cause considerable disruption to daily life on their own.

Developers of migraine drugs have so far focused on treating the headache itself, and no therapies have been effective at alleviating these early symptoms.

But ubrogepant has shown promise in stopping migraine headaches if taken when early symptoms strike, prompting Peter Goadsby at King’s College London and his colleagues to look at whether it can dispel these, too.

They ran a study with 438 people, aged between 18 and 75, who had a history of migraines. Half the participants took a 100-milligram dose of ubrogepant when they felt symptoms suggesting a migraine headache was on its way, while the other half unknowingly took a placebo. Then, the next time prodromal symptoms hit, the participants took the opposite pill.

After taking ubrogepant, they self-reported improvements in their ability to concentrate an hour later, as well as reduced sensitivity to light 2 hours later, and less fatigue and neck pain after 3 hours, compared with what they experienced when taking the placebo. Participants reported that dizziness and sensitivity to sound also lessened when they took ubrogepant.

“If they took ubrogepant, people were more likely to have a reduction in those non-pain symptoms, even before the pain starts,” says Goadsby.

The study did not investigate the drug’s effect on aura, another early migraine feature that involves sensory disturbances that can affect vision, such as flashing lights and blind spots.

“Given that common prodromal symptoms are often functionally disabling, the potential to intervene earlier in the migraine cascade is clinically meaningful,” says Parisa Gazerani at Oslo Metropolitan University in Norway. Further studies are needed to confirm it is broadly applicable, though, she adds.

“This research shows the potential for migraine treatments to reduce these early symptoms, as well as preventing the main headache stage of an attack,” says Rob Music, who leads The Migraine Trust in the UK. “We look forward to seeing further research in this area to help reduce the impact of migraine for the 1 in 7 living with the condition.”