Neurostimulators are an emerging treatment option for migraine patients who want non-pharmacologic treatment. Find out what you know about the three devices approved for use in the US.
Background. The use of neurostimulators in the treatment of migraine headache is relatively new, so it's crucial that primary care providers have a basic knowledge of the three FDA-approved stimulators currently on the market. In the US, all three stimulators require a prescription.
Answer: True. The Cefaly device stimulates the upper branch of the trigeminal nerve including the supraorbital.
There are three FDA-approved Cefaly devices to offer patients. Cefaly Acute, used for acute migraine treatment, and Cefaly Prevent, used for migraine prevention, both cost $349. Cefaly Dual can be used for both acute migraine treatment and migraine prevention and costs $499. There is a 60-day money back guarantee on all devices. More information is available for patients and providers at: www.cefaly.us.
True or false? The SpringTMS device is FDA-approved only for the acute treatment of migraine with aura.
Answer: False. When the SpringTMS device first became available in the US, it only had an indication for acute treatment of migraine with aura. Now, it has the additional approval for acute treatment of migraine without aura in adults aged 18 years and over.
The SpringTMS has been replaced by the SpringTMS mini-a smaller, more portable device. SpringTMS mini is a rental unit and is shipped to the patient after a prescription is sent in to the manufacturer eNeura. The rental fee is $250 per month but a discount is available for the first 3 months. For patients and providers wanting to learn more, the website is www.eneura.com.
True or false? The GammaCore device is FDA-approved only for the acute treatment of cluster headache in episodic cluster headache patients.
Answer: False. The GammaCore device is FDA-approved for the acute treatment of both migraine and cluster headache attacks.
The cost is about $500 per month (a “refill” device is required every month) and requires a prescription from a health care provider. There is a free 1 month trial period for migraine patients and up to a 3-month free trial for episodic cluster headache patients who agree to participate in a registry and track their headache response. For providers and patients wanting to learn more, the website is www.gammacore.com.
Neurostimulators are emerging as a treatment option for migraine headache patients seeking non-pharmacologic treatment. A basic knowledge and understanding of the current stimulators available can help primary care physicians counsel headache patients and make an optimal therapeutic choice. Exactly how and where they fit into headache managment will become clearer as the tehcnology continues to evolve.