Objective:

This study evaluated whether glucagon-like peptide-1 (GLP-1) receptor agonist therapy reduces migraine frequency and disability.

Background:

Migraine is a disabling neurologic disorder characterized by severe, unilateral, throbbing pain lasting 4-72 hours accompanied by nausea, vomiting, and/or sensitivity to light, sound or movement¹. Affecting an estimated 40 million Americans², migraine disease causes significant disability across multiple social domains³. Migraine prevalence, frequency, and severity has been linked to obesity in adults⁴. Approximately 70% of the US Adult population is currently classified as overweight or obese⁵. Emerging evidence for the migraine-obesity link has led to new proposals for using weight loss as a treatment for migraine. In recent years, GLP-1 agonists have been shown to be effective in promoting weight loss⁶. We hypothesized that use of GLP-1 agonists in the treatment of obesity may also benefit patients with high frequency migraines.

Design/Methods:

This retrospective review of electronic medical records included 26 migraine patients prescribed GLP-1 receptor agonists for metabolic indications. Patients were selected if they had received GLP-1 therapy for ≥1 year, with Migraine Disability Assessment (MIDAS) scores extracted from visits one year before and after prescription.

Results:

Mean reductions in headache days (7.0 ± 25.7/3 months) and MIDAS scores (3.3 ± 30.1) were not statistically significant (p=0.599, p=0.493). Outcomes varied markedly (−83 to +39 days; −73 to +55 MIDAS). Six patients (23%, N=26) achieved ≥30-day reductions, and 13 patients (50%) showed MIDAS improvement.

Conclusions:

GLP-1 therapy did not significantly reduce migraine outcomes overall, but responses varied widely, including dramatic improvements in some patients. This variability suggests potential migraine subtypes with differential GLP-1 responsiveness. Larger prospective studies are needed to identify responder characteristics and guide targeted therapy.