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S3E10 | GLP-1 Medications and Migraine - Exploring the Pressure Hypothesis
🧠 Episode Summary
Could a medication designed for weight loss change how we think about migraine prevention? In this episode, host Diana Langworthy sits down with returning guest Dr. Natalie Heinrich, PharmD and student contributor Nena Abosi, PharmD Candidate 2026 to unpack a 2025 Headache pilot study evaluating liraglutide as an add-on therapy for adults with obesity and high-frequency or chronic migraine. The team breaks down study design, results, and limitations while questioning whether the observed benefit stems from weight loss, intracranial-pressure changes, or something else entirely.
💬 Key Takeaways- Study Design: Prospective open-label pilot (n = 31) using liraglutide 1.2 mg daily × 12 weeks in adults with BMI > 30 kg/m² and ≥ 8 headache days/month unresponsive to ≥ preventives.
- Results: Headache days decreased by ~9 per month (≈ 50 % reduction); disability scores improved significantly, but BMI change was minimal.
- Mechanism: Benefit appeared independent of weight loss—raising curiosity about GLP-1 effects on intracranial pressure and CGRP release.
- Tolerability: Mild GI symptoms (~40 %), no discontinuations.
- Caveats: Small sample, no control group, single center — results are hypothesis-generating, not practice-changing.
- Clinical Pearl: Pilot studies like this spark conversation and awareness for emerging mechanisms while reminding clinicians to stay evidence-curious.
- Braca S, Russo CV, Stornaiuolo A, et al. Effectiveness and tolerability of liraglutide as add-on treatment in patients with obesity and high-frequency or chronic migraine: A prospective pilot study. Headache. 2025; 00: 1–8. doi:10.1111/head.14991
- Natalie Heinrich, PharmD, BCPS – Clinical Pharmacist in Neurology, M Health Fairview
- Nena Abosi, PharmD Candidate (2026) – University of Minnesota College of Pharmacy
- Diana Langworthy, PharmD, BCPS – Associate Professor, University of Minnesota College of Pharmacy
Have a study you'd like us to decode on a future episode? Send it our way at [email protected]. We'd also love to hear your thoughts—drop a comment, share your takeaways, or let us know how you're using this evidence in practice.
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By Diana Langworthy🧠 Episode Summary
Could a medication designed for weight loss change how we think about migraine prevention? In this episode, host Diana Langworthy sits down with returning guest Dr. Natalie Heinrich, PharmD and student contributor Nena Abosi, PharmD Candidate 2026 to unpack a 2025 Headache pilot study evaluating liraglutide as an add-on therapy for adults with obesity and high-frequency or chronic migraine. The team breaks down study design, results, and limitations while questioning whether the observed benefit stems from weight loss, intracranial-pressure changes, or something else entirely.
💬 Key Takeaways- Study Design: Prospective open-label pilot (n = 31) using liraglutide 1.2 mg daily × 12 weeks in adults with BMI > 30 kg/m² and ≥ 8 headache days/month unresponsive to ≥ preventives.
- Results: Headache days decreased by ~9 per month (≈ 50 % reduction); disability scores improved significantly, but BMI change was minimal.
- Mechanism: Benefit appeared independent of weight loss—raising curiosity about GLP-1 effects on intracranial pressure and CGRP release.
- Tolerability: Mild GI symptoms (~40 %), no discontinuations.
- Caveats: Small sample, no control group, single center — results are hypothesis-generating, not practice-changing.
- Clinical Pearl: Pilot studies like this spark conversation and awareness for emerging mechanisms while reminding clinicians to stay evidence-curious.
- Braca S, Russo CV, Stornaiuolo A, et al. Effectiveness and tolerability of liraglutide as add-on treatment in patients with obesity and high-frequency or chronic migraine: A prospective pilot study. Headache. 2025; 00: 1–8. doi:10.1111/head.14991
- Natalie Heinrich, PharmD, BCPS – Clinical Pharmacist in Neurology, M Health Fairview
- Nena Abosi, PharmD Candidate (2026) – University of Minnesota College of Pharmacy
- Diana Langworthy, PharmD, BCPS – Associate Professor, University of Minnesota College of Pharmacy
Have a study you'd like us to decode on a future episode? Send it our way at [email protected]. We'd also love to hear your thoughts—drop a comment, share your takeaways, or let us know how you're using this evidence in practice.