Yes, you heard right. The app will actually be the prescription. A digital prescription. Sort of.
This past week Click Therapeutics reached a milestone when the FDA approved their application for their digital app, currently known as CT-132. It’s an app specifically designed to treat migraine.
No, you don’t inject yourself with it or hold the phone close to your head to make it vibrate. It’s actually more about helping you with lifestyle changes. Yes, we’ve seen things like this before, but this is a specific app that has gone through clinical trials.
This isn’t Click Therapeutics’ first app. They already have an app available for major depressive disorder, known as Rejoyn. The official website explains: “Rejoyn, when used alongside your antidepressant medication, can help you treat depression symptoms differently. It is authorized by the FDA and provides 6 weeks of brain-training exercises and short skills-based therapy lessons.”
They also have an app for type 2 diabetes. And more to come, but the migraine one is coming soon.
We can expect to see more apps of this type coming.
One of the important measurements for an app of this kind is whether or not people will use it, and keep on using it. Only after that can we measure whether or not it’s helping. CT-132 seems to check both boxes, after a few weeks in the trials.
Of course, this is bit of a different kind of thing to test, when we compare it to taking a pill. But so far it does seem to help. But the real trial will come when it’s available and people in the real world start using it.
Over the past many years that I have written about headache disorders, every once in a while there’s something that helps a lot of people. Everyone is unique, of course, so often it’s the little things that help a few people here and there.
But I’m talking about things that have helped a wider number of people, just based on the unscientific feeback I get. 🙂 One of those things has been magnesium – a simple thing that has helped a lot of people. We’ve talked about it a lot.
But I’ve also received a lot of feedback on the work of Dr. Josh Turknett. Dr. Turknett is a neurologist who has studied migraine and diet extensively, and he has written two helpful books:
This is an introduction to his research on migraine, with lots of helpful tips. It explains his approach to migraine from the bottom up. If you want to understand more about migraine and learn how to take specific steps to fight it, I highly encourage you to start here.
Don’t be put off by the title – even if you’re not ready to go hard-core keto, this book helps you design a migraine-fighting diet that could make a huge difference in your life. And, of course, that’s my whole point – these books have helped a wide range of people fight migraine in practical ways.
The human body is incredibly complex. A full understanding of how it works and how it’s all balanced together is still far beyond the reach of modern science. And so there’s a lot to talk about.
Oxalates are natural chemicals in your body, and are also found in some foods, such as (you guessed it) spinach, almonds, peanuts, potatoes, chocolate, carrots and raspberries.
Oxalates have become a topic of conversation partly because of the popularity of the book Toxic Superfoods by Sally K. Norton. But the book has also been highly criticized as more health-hype than health-fact.
The fact of the matter is that oxalates have been a concern in the health field for more than a century. As early as 1933, migraine among other things was being connected with too much oxalate intake.
As with anything, there’s too much of a good thing. It’s not so much controversial that too many oxalates collecting in the body can cause problems (such as, most famously, kidney stones).
The controversy instead centres around just how common oxalate problems are, and just what kinds of health conditions they can cause. Some of the criticisms around Norton’s book, for example, are that she seems to associate almost every health condition and the fall of western civilization to eating too many oxalates.
I exaggerate, of course, and I think that some of these criticisms are a bit unfair as well. The fact is that our bodies are indeed complex, and doctors are often very hesitant to blame health issues on diet unless the connection is direct and obvious.
The nature of this controversy means that, if you’re interested in investigating it, you’ll need to do more than watch a couple of videos on YouTube. It will take some time to look at various sides of the issue, and to take a good look at what your body is telling you.
Norton is suggesting (among other things) that in many ways modern health crazes are pushing our bodies out of balance. To suddenly load up on spinach smoothies may indeed be too much of a good thing. And certain diets, in their effort to duplicate and feed our every craving, end up causing two problems as they solve one.
Even the question of which foods will cause problems with your oxalates can be complicated. But if you’re dealing with health issues and want to investigate diet solutions, I recommend looking into this question and making your own decision. Take a look at some of the foods commonly said to be high in oxalates. And do some serious reading of the research.
Norton’s book is one resource you can check out. But be warned that this is not a light, motivational self-help read. To understand her side of the issue, I strongly recommend you take the time needed to understand it. And she does address some of the concerns of her opponents – you can decide if her answers are helpful/satisfactory.
This issue raises some important general questions. Is it hopeless to try to improve our diets? Will the research of 2029 completely change diet recommendations for migraine and other similar conditions that we had in 2024? How can we make the best decisions now without being caught in fads that might not serve us well? Science is a moving target, and it should be, since it’s based on questioning and retesting. But we still want to make the best decisions we can by wisely interpreting the information we have today.
There are some rules that seem timeless, and moderation is one of them. And that may indeed be part of the issue with oxalates. But the human body is much more complex than a “just do this” diet can address. Your body changes as you get older. Rapid industrialization is changing the food that is available to us, meaning that the nutrients in common foods may not be what it was a hundred years ago. Migraine sufferers have specific needs that may not be addressed by “fad diets” anyway.
There are general rules that can be helpful. But in the world today, don’t expect a silver bullet that will solve all your health issues. It’s going to take some work. But we’re up for it!
It’s been over 15 years (!) since I first wrote about the benefits of deep brain stimulation for cluster headache. It wasn’t a brand-new treatment at that time. However since cluster is fairly rare, it takes a lot longer to collect useful information.
A recent publication in BMC Neurology had a review of studies of DBS, both older and newer. And their findings were positive.
Not every patient benefited. This is important to say from the start. One of the current and future goals of researchers is to understand why DBS is helpful for some patients and not for others, so that no one has surgery that won’t really help.
That being said, many patients did benefit significantly. The study notes: “Patients who responded positively to DBS often experienced long-term benefits, with sustained reductions in CH symptoms even after several months to years of follow-up. Quality of life measures consistently showed improvements among responders, suggesting that DBS not only reduces pain but also enhances overall well-being.”
Adverse effects were usually temporary and not serious. A common one was double vision (diplopia), but again it was usually only a temporary issue, compared to the long-lasting effects benefits of the treatment.
As mentioned above, “overall well-being” was improved. One notable reason for this was that DBS sometimes seems to cut down on nighttime cluster attacks, improving sleep. That’s a huge benefit.
Research will continue, but in answer to the question “how’s it going?” – it’s going well. Deep brain stimulation is still beneficial to many cluster headache patients.
It’s hard to believe that it has now been seven years since the FDA approved Ajovy (fremanezumab-vfrm) for migraine. But seven years it has been. And this month it has been approved for paediatric use for those with episodic migraine (more information).
Ajovy is one of the CGRP related medications (a calcitonin gene-related peptide antagonist in this case). It’s a preventative, taken by injection. The word “injection” may scare a lot of people off, but the nice thing about Ajovy is that it’s only taken once a month – or, over the course of a day every three months. It also uses an “autoinjector” which is fairly easy to use, unlike old-fashioned needles (been there!).
It’s not surprising that many people prefer something taken every three months to a pill taken every day. And Ajovy continues to be a success story for many, significantly or even drastically reducing their days with migraine symptoms.
Appropriately, we are a lot slower to approve medications for children. But Ajovy now provides another option for many children suffering from migraine, and in this case something that won’t be a daily complication.
The details? Ajovy has been approved for children ages 6-17, who weigh at least 45kg or 100 lbs. The quarterly injections have not been approved, only the monthly injections – a dosage of 225mg (the same as the monthly dose for adults).
The weight of the patient is an important factor, because we still don’t know of a dose that will be effective and yet still safe for lower weights.
As with trying any new medication, you should watch for any unwanted symptoms. Some people have reported skin problems around the injection site, something that can probably be treated to diminish the discomfort. Be sure to talk to your doctor if you have any concerns.
