I am 33. Are CGRP injections effective for my migraine?

Question

Hello doctor,

I am a 33-year-old woman with chronic migraines, sometimes 12–15 days a month. I have tried Triptans and preventive tablets like Propranolol, but they do not work well and cause side effects. My neurologist suggested trying CGRP (Calcitonin gene-related peptide) monoclonal antibody injections. Please tell me;

Are these injections safe for women of childbearing age?
How effective are they in reducing migraine frequency compared to Botox therapy?
Are they meant to be lifelong treatments or just temporary?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

CGRP (Calcitonin gene-related peptide) monoclonal antibodies (such as Erenumab, Fremanezumab, Galcanezumab, and Eptinezumab) are a newer class of migraine drugs that specifically block the calcitonin gene-related peptide pathway, which is strongly involved in migraine attacks. For women of childbearing age, these injections are generally considered safe in the short and medium term. However, safety data regarding these drugs during pregnancy are limited.

Most neurologists recommend avoiding them if you are planning pregnancy, actively trying to conceive, or breastfeeding, and using effective contraception while on therapy. In terms of effectiveness, studies show that CGRP antibodies can reduce migraine by about 50 percent or more. They often work fast with fewer systemic side effects compared to traditional medicines.

Botox (onabotulinumtoxinA), which is approved for chronic migraine (more than 15 headache days per month), is also very effective. But CGRP antibodies may provide a greater reduction in monthly migraine days for some patients, particularly if you do not tolerate or respond to Botox.

Some patients even combine both of these for their migraine. As for duration, these injections are not necessarily a lifelong treatment. Most people continue them as long as they provide meaningful benefits and the side effects are minimal. If migraine frequency drops significantly and remains low for an extended period, your neurologist may suggest stopping.

Ultimately, the choice between Botox and CGRP antibodies depends on your migraine pattern, treatment response, tolerability, cost, and pregnancy plans, and it should be individualized in close consultation with your neurologist.

I hope this information helps you.

Feel free to ask further queries.

Thank you.