On a rainy, hot day in South Florida, Sophia Gonzon’s head is throbbing. Walking over, Dr. Maike Blaya injects Botox into the young woman’s scalp, jawline, neck, forehead and shoulders. Gonzon closes her eyes, willing the botox to work and her painful migraine to ease.
Gonzon, 22, of Boca Raton, spends at least one week a month lying in a dark room, waiting for the pain, sensitivity to light and dizziness to go away.
Lately, though, life has been somewhat better for the up-and-coming recording artist.
Blahheadache specialist at the Memorial Neuroscience Institute Headache Center;he found a combination of remedies to relieve Gonzon.
When the heat of summer arrives, experts like Blaya see more demand for headache relief. According new research from the University of Cincinnati’s Gardner Neuroscience Institute, rising temperatures can trigger painful migraines and more headache incidents.
“Weather change is one of the most common migraine triggers,” states a news release from the University of Cincinnati.
“About 90 percent of people are unable to function when migraine attacks occur,” Blaya said. “Fortunately, we can do a lot now for patients. For almost everyone who comes to see us, we have something to offer them.”
New breakthroughs in migraine treatment bring some hope this summer to Florida sufferers.
Migraines affect at least 39 million Americans, with women three times more likely to suffer from them than men, according to the American Migraine Foundation. A migraine attack is much more than just a terrible headache. It can include neck pain, nausea, dizziness, and sensitivity to light, sound, and smell. Sufferers often miss entire days, too disabled by the condition to complete their daily tasks.
Gonzon said migraine triggers are stress, diet, smells or weather. Some women experience migraines caused by changes in their hormones that coincide with their menstrual cycle.
So far, there’s no cure for migraines, but Blaya and other headache specialists are helping Florida patients manage their symptoms.
Blaya’s arsenal includes devices, nasal sprays, injections, infusions and medications.
Blaya gives Gonzon a combination of Botox injections every 10 weeks and Ubrelvy, a newer oral migraine drug that directly blocks a protein known as CGRP, which is thought to play an important role in migraine attacks.
Specialists use this new class of drugs called anti-CGRP (calcitonin gene-related peptide) medicines to treat or shorten a migraine attack. Drugs that block CGRP block the effects of this protein to try to prevent migraine attacks, shorten them, or reduce pain. Over the past five years, the FDA has approved several drugs that block CGRP receptors, some taken by mouth when a migraine occurs and some given on their own monthly or quarterly to prevent migraine attacks from occurring.
“We have some patients who have tried them and are migraine-free,” Blaya said.
Gonzon, whose headaches started in her pre-teens, tried myraid pills and devices, and still found herself crippled by migraines. Blaya’s combination of treatments is the first time her symptoms are less frequent, she says. He was able to record music in a Los Angeles studio and has just released a new single called ‘Miss Me’.
“Overall the number of days I suffer is reduced, but I don’t think the migraines will completely go away,” Garzon said. “Migraine disorders are an invisible disease and there are not enough advocates for it.”
At the University of Miami Health System, Dr. Teshamae Monteithhead of the Headache Department, studies migraines and collaborates in research with colleagues.
“Even with all these new treatments, migraine is still underdiagnosed and undertreated,” Monteith said, “Only a minority of people who are diagnosed are aware of the developments and receive appropriate treatment.”
At her clinic, specialists enroll patients in trials for various treatments.
In the past five years, advances in treatments have included wearables. The FDA has approved four migraine devices that deliver electrical impulses to the nerves that can trigger a migraine. They are worn in different areas of the body: forehead, neck, arm or head.
Monteith and her colleagues are investigating a device worn around the arm that uses a phone app to stimulate a pain-relieving response.
She and other researchers are also studying a nasal spray that reverses an acute headache attack and a breathing device for adults who suffer from migraine attacks with aura.
And like Blaya at Memorial, they’re looking at the combination of anti-CGRP drugs and Botox to see if the pairing leads to fewer migraine days per month. “We already use this combination, but the clinical trail is important to collect the data and get it back to the insurers,” Monteith said.
One of the challenges, Monteith says, is that not all available treatments are covered by insurance, and some can be expensive. “We are doing our best to come up with these great strategies. Sometimes cost and insurance is a barrier and that’s where advocacy comes in,” he said. “Many patients depend on voucher programs to subsidize costs.”
Monteith says migraines can vary in intensity, where in the head they occur and their triggers.
“It’s important to tailor the best regimen to the patient, which could include newer therapies, older therapies, or a combination that includes behavioral therapies, like more lifestyle things,” he said. “It really depends on what their needs are and where the migraine is. It is also important to give people what they are really going to get. You know, compliance is a huge issue.”
In the future, a new class of drugs could be available. Researchers study antibodies that specifically target pituitary adenylate cyclase-activating peptide (PACAP) receptors that can trigger a migraine attack. Migraine researchers believe that once an effective PACAP inhibitor is found, doctors will have yet another drug to add to their treatment arsenal.
The bottom line: There is hope for people living with migraine attacks.
“We have some people who have achieved freedom or close to it,” Monteith said. “If you are not seeking help for your migraine, I encourage you to start. We have so many new treatment options, with many more coming to the stage.”
Gonzon has become his representative Migraine Disorders Associationgrateful for advances in treatments She still has to take frequent breaks while recording pop songs, but the singer-songwriter will release new music this month. “I can definitely function a lot more than before,” he said.
South Florida Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.
