About one-third of migraine sufferers find no relief from standard treatments. However, new research suggests that utilizing the brain’s waste-clearing system could introduce innovative treatment methods. A particular drug that is typically used to manage high blood pressure demonstrated the ability to effectively eliminate chemicals from the brains of mice that contribute significantly to migraines. Consequently, the mice showed minimal facial pain.

Around 60% of migraine patients experience considerable discomfort during episodes.

Globally, approximately 1 in 7 people suffer from migraines. Symptoms include pain, pressure, and tingling in areas such as the cheeks, jaw, forehead, and behind the eyes, often worsened even by light touch. “Just brushing your hair can result in excruciating pain for those living with migraines,” stated Adriana Della Pietra, who presented findings at the Oxford Glymphatic and Brain Clearance Symposium in the UK on April 1.

Conventional treatments for migraines, including triptans, aim to reduce inflammation and lower the levels of a neurotransmitter known as calcitonin gene-related peptide (CGRP), a key player in migraine pathology. CGRP is a major factor driving migraines, targeted by many standard treatments. “Unfortunately, many individuals do not respond to these medications and are frequently trapped in a cycle of debilitating pain,” commented Valentina Mosienko from the University of Bristol, UK, who was not involved in the study.

In previous studies, researchers discovered that prazosin, a medication prescribed for high blood pressure, alleviated facial pain caused by traumatic brain injuries in mice. Traumatic injuries can impair the brain’s waste disposal system, known as the glymphatic system, and prazosin enhanced fluid flow from brain cells through this system. Interestingly, it also appeared to benefit some migraine models used as control groups.

To delve deeper, the research team administered prazosin to one group of mice in their drinking water over six weeks, comparing against a control group that received standard water. Subsequently, both groups were subjected to migraines induced by CGRP injections.

After 30 minutes, the researchers applied progressively thicker plastic filaments to the mice’s foreheads. This technique, normally non-painful, became more detectable as the filaments increased in thickness. The findings showed that mice receiving prazosin managed to endure significantly thicker filaments without flinching compared to control mice. Della Pietra noted that the prazosin group behaved similarly to mice that hadn’t received CGRP injections.

Further analysis revealed that prazosin not only reversed the impairment of the glymphatic system caused by CGRP but also likely enhanced the clearance of CGRP and other pain-transmitting molecules, as reported by Della Pietra.

Research teams are eager to examine whether similar results can be replicated in humans. “If it proves effective in humans, that would be a tremendous breakthrough,” Mosienko added. “Since this drug is already in use, we have established safety for its application.”