CGRP and Butterbur: Comparing the Evidence

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Key Questions
  • Of the four injectable forms of CGRP antagonists, how are they similar and how are they different?
  • How soon should someone who tries CGRP antagonists expect to see results, and if someone tries one and it fails, should they try another type of anti-CGRP treatment?
  • How much do the CGRP antagonists cost?
  • How can the average person with migraine afford them?
  • For those people who respond to CGRP antagonists, what kind of response should they expect?
  • How many people do not get the desired response from the anti-CGRP treatments?
  • Based on what we see happening in those super responders to the anti-CGRP treatments, is it possible that a migraine cure could be developed?
  • Do anti-CGRP treatments reduce other symptoms such as neck pain, allodynia, fatigue, brain fog, nausea, etc.?
  • How do CGRP antagonists address the different types of migraine diagnoses, such as chronic, episodic, hemiplegic, and vestibular migraine, as well as cluster headache and new daily persistent headache?
  • Why is there often a reluctance on the part of physicians to using supplements like magnesium, feverfew, and butterbur to treat and/or prevent migraine?
  • If somebody is going to consider supplements such as butterbur, feverfew, or magnesium as a therapy, is there any guidance on the types of these herbs or supplements to look for?
Interview Notes

Find more about Pierangelo Geppetti, MD and his work here:

profile-pierangelo-geppetti

Pierangelo Geppetti, MD

Professor in the Department of Health Sciences
University of Florence, Italy

Pierangelo Geppetti, MD, is a professor of clinical pharmacology at the Medical School of the University of Florence, and is the director of the Headache Center and Clinical Pharmacology Unit of the University Hospital of Careggi, Florence. Dr. Geppetti is an expert in the pharmacology of neuropeptides, particularly in the field of neurokinins and calcitonin gene-related peptide (neurogenic inflammation). He is a member of the Board of the Italian Association for the Study of Pain and of the Italian Society for the Study of Headaches.

His scientific activity has focused on primary sensory neurons and neurogenic mechanisms of inflammation in migraine and other types of pain. Dr. Geppetti has authored more than 200 articles in peer-reviewed journals and is co-author of a series of papers on the physiopharmacology of pain transmission and inflammation.

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