Migraines | Women's Health Series

Join us in a conversation with Dr. Addie Peretz, a Clinical Assistant Professor of Neurology & Neurological Sciences at Stanford University. We discuss the prevention and treatment of migraines with the use of new medications such as Gepants, CGRP antagonists, and neuromodulatory devices. Our discussion includes how hormonal fluctuations, such as, pregnancies and perimenopause affect migraines and which medications we can safely consider during a women’s child-bearing years. We also provide insights on preventing migraines, managing lifestyle factors, and utilizing complementary approaches.
Key moments:
00:00 Introduction to Women's Health Vodcast Series
1:09 What led you into this field of migraine and headaches?
2:00 How common are migraines and why is this such an important women's health issue?
2:50 What exactly defines a migraine headache from other types of headaches?
5:50 How can women’s migraines expect to change as they become pregnant?
7:30 Can you talk about how migraines are affected during the perimenopause and menopause period?
8:58 Can you remind us who we should not be prescribing triptans to?
9:30 Is there any benefit to trying another triptan?
11:39 Which ones would be the fastest acting triptan?
12:03 Can you tell me more about this new class of medications?
14:25 Are there any contraindications we should be wary of?
15:30 Can you tell me when you would use this medication?
16:31 Do you think pcp should become more comfortable prescribing gepants if patients aren’t responding to triptans?
17:59 Do you have medication that you feel better works for patients?
19:32 What else can we do to support patients at home?
21:53 Can you talk more about these neuromodulatory devices?
23:48 Do they require prescription?
24:28 What can patients use during pregnancy?
27:44 Can you elaborate on whether or not we can use continuous birth control for patients with menstrual migraines?
30:12 Do IUDs have any impact on migraines?
30:55 What can I tell patients what to expect when they’re having perimenopause migraines?
31:59 When do you start to consider a prescription for prophylactic medication for migraines?
33:48 How effective are over the counter supplements for migraine prevention?
34:58 What nutraceuticals do you recommend to start with?
35:55 What generally is your go to prescription prophylactic to start with?
37:42 How does that work if they are also on a CGRP for a board of therapy?
39:40 What would they be able to take on a board of therapy?
40:32 What can be used in the pre conception and perinatal period?
42:43 Can you expand upon which medications we should take months off in advance before someone tries to get pregnant?
46:29 Do you see a role in complementary medicine in helping with migraines?
48:17 Are there any other aspects of migraine treatment that you think are important?
50:09 What do you think helps patients transition medication?
51:57 Are there any emerging technologies you find exciting?