Migraine meds: Cheaper is better

When it comes to migraines, the first-line meds aren’t the best ones — at least according to a new study out of Norway that looked at a decade’s worth of health data of more than 100,000 people.

The top line: amitriptyline, CGRP inhibitors, and simvastatin work better than beta blockers to prevent migraines. But the bottom line is also worth noting: amitriptyline and simvastatin are darned cheap compared to beta blockers or CGRP inhibitors.

With that simvastatin finding, their next step will be “to measure the effect of established cholesterol-lowering medicines as a preventive measure against chronic and episodic migraine.”

More free Covid tests

The federal government is once again offering free Covid-19 tests — four per household, beginning yesterday (November 20). This is in addition to the free tests it offered in September.

Just head over to Covid.gov/tests and order ’em.

Don’t forget to nominate someone

Do you know a great student pharmacist? An amazing technician? Or a pharmacist who goes above above and beyond?

It’s time to tell us about it — to nominate someone for one, two, or more 2024 GPhA awards. They’ll be presented at the 2024 Georgia Pharmacy Convention on Amelia Island, but first we need to know who deserves them.

Head over to GPhA.org/awards to see the list of awards, the criteria, and how to nominate someone. The deadline for nominations is January 19, 2024, so don’t wait too long!

Food allergies: when silent is deadly

Researchers at the University of Virginia Health System have stumbled upon a curious link: Common food allergy antibodies, known as IgEs, might increase the risk of heart problems.

Important twist: Even people with a low-level immune response to foods like peanuts or cow’s milk — not even an allergy — could be affected.

The researchers analyzed data from around 5,400 individuals and found that those with IgE antibodies to any food had a higher chance of cardiovascular death. (Milk allergies had the strongest connection, but peanut and shrimp allergies were pretty high.)

And people without obvious food allergy symptoms? They were most at risk.

Hypothesis: These antibodies might activate mast cells, which are not only involved in allergic reactions but are also found in heart tissue. As usual, of course, more research is needed.

Drug makers try to shift blame

Makers of ADHD drugs are trying to blame the federal government for their shortages, claiming government production limits are at least partially to blame.

This isn’t true. As we covered earlier this month, drug makers are actually not reaching those production limits, and the feds have resorted to pressuring them to do so and make more meds.

Nice try, though.

Faster drugs, more addiction

When drugs are taken intravenously, they work faster. (You are permitted to say “Duh” at this point.)

Interestingly, people are also more likely to become addicted to a drug if they take it intravenously (or by smoking) rather than by mouth (or nose). [T]he faster a drug enters the brain, the more addictive it is.”

Why this is true wasn’t clear — until NIH researchers looked into it. First of all, they found, there’s the quicker dopamine hit. But it’s more complex than that. Get this: Taking the same drug intravenously will have different effects than taking it orally.

Apparently taking a drug intravenously activates a part of the brain called the salience network, while taking the same drug orally does not. The salience network lets the brain monitor sensations like the effect of drugs, so it’s as if the brain is telling itself, “This is good stuff.” It’s so powerful that people who sustain damage to the salience network “can have a complete remission of their addiction.”

This means, the scientists says, that targeting parts of the salience network might be a way to treat addiction.

Elsewhere: Weight-loss coverage?

Medicaid directors in five states — Illinois, Massachusetts, New Mexico, Utah, and Vermont — have said they’re considering adding GLP-1 inhibitors for weight loss to their state’s coverage. The idea is that helping people lose weight will pay off in the broad health benefits it provides, saving money in the long run.