Over the past decade or so, I’ve been suffering with chronic migraine, sometimes with multiple attacks per week. It’s been a curse — not only do you have to suffer the periodic migraine attacks, but also the “prodrome”, where unpleasant symptoms like brain fog and an inability to concentrate can impact you.
After a long process of getting a referral to the appropriate headache clinic, and eliminating other possible medications, I finally got approved to receive Ajovy (fremanezumab), one of the new generation of CGRP inhibitor monoclonals — these work by blocking the action of a peptide on receptors in your brain. I started the course of these a month ago.
The results have, frankly, been amazing. As I hoped, the migraine episodes have reduced in frequency, and in impact; they are now milder. But on top of that, I hadn’t realised just how much impact the migraine “prodrome” had been having on my day-to-day life. I now have more ability to concentrate, without it causing a headache or brain fog; I have more energy and am less exhausted on a day-to-day basis; judging by my CPAP metrics, I’m even sleeping better. It is a radical improvement. After 10 years I’d forgotten what it was like to be able to concentrate for prolonged periods!
They are so effective that the American Headache Society is now recommending them as a first-line option for migraine prevention, ahead of almost all other treatments.
If you’re a migraine sufferer, this is a game changer. I’m delighted. It seems there may even be further options of concomitant treatment with other CGRP-targeting medications in the future, to improve matters further.
More papers on the topic: a real-world study on CGRP inhibitor effectiveness after 6 months; no “wearing-off” effect is expected.