Summer migraines come on fast and hard. South Florida headache specialists offer new treatments

On a hot, rainy day in South Florida, Sophia Garzon’s head is pounding. Leaning over her, Dr. Maike Blaya injects Botox into her scalp, jaw, neck, forehead and shoulders. Garzon closes her eyes, hoping the Botox will take effect and her painful migraine will subside.

Gonzon, 22, of Boca Raton, spends at least a week each month lying in a dark room, waiting for the pain, sensitivity to light and dizziness to subside.

But lately, life is a little better for the up-and-coming artist.

Blaya, a headache specialist at the Memorial Neuroscience Institute Headache Center, discovered a combination of therapies to help Garzon.

When the summer heat hits, specialists like Blaya see an increased demand for headache relief. Rising temperatures can trigger painful migraines and an increase in headache cases, according to a new study from the University of Cincinnati’s Gardner Neuroscience Institute.

“Climate change is one of the most common triggers of migraine,” states a press release from the University of Cincinnati.

“About 90 percent of people can’t function properly when they have migraine attacks,” Blaya says. “Fortunately, there’s a lot we can do for patients now. We have something to offer almost everyone who comes to see us.”

New breakthroughs in migraine treatment are bringing some hope to Florida sufferers this summer.

Migraines affect at least 39 million Americans, with women three times more likely to suffer than men, according to the American Migraine Foundation. A migraine attack is more than just a terrible headache: It can be accompanied by neck pain, nausea, dizziness, and sensitivity to light, sound, and smells. Sufferers often lose entire days, too incapacitated by the condition to perform daily tasks.

According to Garzon, triggers for her migraines include stress, food, smells or the weather. Some women experience migraines caused by hormonal changes, which coincide with their menstrual cycle.

So far, there is 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 new oral migraine drug that directly blocks a protein known as CGRP, which is thought to play a major role in migraine attacks.

Specialists are using this new class of drugs called calcitonin gene-related peptide (CGRP) blockers to treat or shorten a migraine attack. CGRP-blocking drugs block the effects of this protein to try to prevent migraine attacks, shorten them, or lessen the pain. Over the past five years, the FDA has approved several drugs that block CGRP receptors, some taken by mouth when a migraine strikes and others self-injected monthly or quarterly to prevent migraine attacks.

“We have patients who have tried these medications and no longer have migraines,” Blaya said.

Gonzon, whose headaches began in her teens, tried a multitude of pills and devices and found herself crippled by migraines. Thanks to Blaya’s combination of therapies, her symptoms are less frequent for the first time, she says. She’s been 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 have pain has decreased, but I don’t think migraines will ever completely disappear,” Garzon said. “Migraines are an invisible disease, and there aren’t enough advocates for this disease.”

At the University of Miami Health System, Dr. Teshamae Monteith, chief of the headache division, studies migraines and collaborates on research with her colleagues.

“Despite all these new therapies, migraine remains largely underdiagnosed and undertreated,” Monteith said. “Only a minority of people who are diagnosed are aware of the advances and receive appropriate treatment.”

In his clinic, specialists enroll patients in trials for various therapies.

Over the past five years, advances in treatment have included wearable devices. The FDA has approved four migraine devices that deliver electrical impulses to the nerves that can trigger migraines. They are worn on different areas of the body: the forehead, neck, arm or head.

Monteith and his colleagues are studying a device worn around the arm that uses a phone app to stimulate a pain-relieving response.

She and her fellow researchers are also studying a nasal spray that prevents acute migraine attacks, as well as a breathing device for adults who suffer from migraine attacks with aura.

And like Blaya at Memorial, they are considering combining anti-CGRP drugs with Botox to see if that combination leads to fewer migraine days per month. “We already use this combination, but the clinical trial is important to collect the data and get it to insurers,” Monteith said.

One challenge, Monteith said, is that not all available treatments are covered by insurance and some can be expensive. “We do our best to develop these effective strategies. Sometimes cost and insurance are a barrier and that’s where advocacy comes in,” she said. “A lot of patients rely on voucher programs to subsidize the cost.”

Monteith explains that migraines can vary in intensity, where in the head they occur and their triggers.

“It’s important to tailor the best treatment to the patient, which may include newer treatments, older treatments, or a combination that includes behavioral therapies like lifestyle changes,” she said. “It really depends on their needs and where the migraine is. It’s also important to give patients what they’re actually going to take. You know, adherence is a big issue.”

In the future, a new class of drugs may be available. Researchers are studying antibodies that specifically target pituitary adenylate cyclase-activating peptide (PACAP) receptors that can trigger a migraine attack. Researchers believe that when an effective PACAP inhibitor is found, doctors will have another drug to add to their treatment arsenal.

Bottom line: There is hope for people suffering from migraine attacks.

“Some people have achieved freedom, or almost freedom,” Monteith said. “If you’re not looking for help for your migraine, I strongly encourage you to start. We have so many new treatment options, and many more are in development.”

Garzon has become a spokesperson for the Migraine Disorders Association, grateful for the advances in treatment. She still needs to take frequent breaks when recording pop songs, but the singer-songwriter will release new material this month. “I’m definitely able to function a lot more than I used to,” she said.

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