The Central Sensitization Simulator
About the Central Sensitization Simulator
The fundamental drawback to migraine abortive medications is that, while they may relieve an existing migraine, they increase the odds of a future migraine. And the effect is cumulative. This is due largely to a phenomenon known as “central sensitization.” Thus, we refer to central sensitization caused by a drug as “Drug-Induced Sensitization”.
The tool below is to help illustrate this principle, and to help you to understand how this effect varies according to the drug (and simplified for the sake of illustration). In this scenario, an individual with a baseline migraine frequency is prescribed a drug and takes it each time he or she has a migraine attack.
The top number indicates their migraine frequency prior to a drug being prescribed (so “30” would be one migraine every 30 days). The bottom number (“sensitization factor”) represents the degree to which the drug increases migraine frequency. The “preset” drug examples all give the days to daily migraine starting with a baseline migraine frequency of once per month (every 30 days).
Note: Opioids are not indicated for the treatment of migraine due to their highly unfavorable benefit to risk profile, but are included in the presets because they are still prescribed.
Key Points:
Here are a
- Every dose matters.
- There’s a misconception that migraine abortive medications only contribute to sensitization past a certain threshold (such as 2 doses per week). This is absolutely false. Each dose contributes, and the effect is cumulative (the higher the dose and the greater the frequency, the faster it accumulates).
- Each drug contributes to sensitization differently.
- Certain drugs are worse than other fueling chronic migraine. The opioids are the undisputed kinds, but triptans, ergots, and combination analgesics aren’t far behind. On the other hand, Naproxen and the CGRP antagonists have far lower sensitization factors.
- Certain drugs are worse than other fueling chronic migraine. The opioids are the undisputed kinds, but triptans, ergots, and combination analgesics aren’t far behind. On the other hand, Naproxen and the CGRP antagonists have far lower sensitization factors.
Strategies for Conquering Drug-Induced Sensitization
These are the key strategies that have helped thousands conquer this issue.
- Make conquering Drug-Induced Sensitization a top priority. Overcoming it will transform your future (and drastically reduced long term suffering).
- Explore all of the non-drug remedies to help relieve pain during a migraine attack to develop your own go-to solutions.
- Understand the phenomenon of Drug-Induced Sensitization so that you can make truly informed decisions about how to treat your migraines.
- If you must take something, try to use the drug with the lowest sensitization factor.
- Implement a holistic program to improve mitochondrial function and reduce inflammation. That said, Drug-Induced Sensitization must be addressed concurrently for the benefits to accrue.