Dr. Lawrence Robbins of the Robbins headache clinic wrote this piece about a year ago. He has been one of the biggest prescribers of these drugs and at this point is saying that "Some headache providers feel that the CGRP monoclonals are safe and adverse effects are infrequently encountered. Others believe, as I do, that the mAbs result in a number of deleterious effects."
He also said "After assessing the various post-approval lines of evidence, there are signals that the following adverse effects may result from the use of CGRP monoclonals: constipation, anxiety, injection site reactions, weight gain or loss, worsening hypertension, increased headache, insomnia, depression, hair loss, joint pain, fatigue, irritability, muscle pain or cramps, nausea, rash, sexual dysfunction, and tachycardia (or other heart irregularities). Most likely there are others as well. In addition, there have been cases of reversible cerebral vasoconstriction syndrome and stroke. Angina and myocardial infarction have also been reported. Thomas Moore, a leading expert in the acquisition of adverse effects of drugs, published a review of the CGRP monoclonals in the online journal QuarterWatch. QuarterWatch utilizes various resources, including FDA reports and published post-approval studies. (5) The report cites the “sheer number of case reports,” and concludes that “…it is likely that adverse effects of this migraine preventive were underestimated in the clinical trials.”
These meds have now caused at least 40,000 serious adverse events and the number of people that I have talked to that completely regret taking this medication is huge. Some of them are still suffering long term effects from it.
And for what it's worth, I agree with Dr. Robbins. If we can have a medication that has this many bad side effects but prescribers still end up convinced that the worst effects are mild constipation, than our system is broken.
Once again, cluster headache patients will need to rely on each other to keep ourselves safe.
https://southernpainsociety.org/adverse-effects-and-clinical-trials-the-system-is-broken/
-Ricardo