How to Talk GLP-1 and Migraine with Your Doctor

1 Big Thing

GLP-1 receptor agonists are being explored off-label for migraine prevention after a small 12-week pilot with liraglutide showed nearly halved monthly headache days in adults with obesity and high-frequency or chronic migraine [1–3].

Why it matters

If this signal holds up in larger trials, GLP-1 therapy could offer a prevention path that acts on brain-pressure biology, not just pain relief. Your visit goes better when you arrive prepared and speak the clinician’s language [2,3].

Between the lines

Evidence is early. Benefits were seen over 12 weeks in a small, open-label study. These medicines are not approved for migraine. Safety screens, realistic goals, and tight follow-up are essential [1–3].

Go deeper

Quick primer to align on terms

GLP-1 receptor agonists include liraglutide, semaglutide, dulaglutide, exenatide, and lixisenatide; a related dual GIP/GLP-1 medicine is tirzepatide. They are approved for type 2 diabetes and/or chronic weight management, not for migraine prevention. Early migraine interest stems from possible effects on intracranial pressure and trigeminal pain pathways [1–3].

What to bring

Come with one page that summarizes:
• Your last 8–12 weeks of headache days, attack length, average severity, and disability impact (e.g., work or school days affected).
• Treatments tried (preventive and acute), best responses, side effects, and reasons you stopped.
• Medical conditions (especially obesity, type 2 diabetes, hypertension, GI issues), current meds and supplements, allergies, and pregnancy plans.
• What success looks like for you over 12 weeks: for example, “cut monthly headache days by at least 30–50% and reduce severity.”

Conversation script (use or adapt)

Start with your goal:
“I’d like to discuss whether a GLP-1 medicine could be appropriate as part of my migraine prevention plan. I understand it’s off-label for migraine, and I’m looking for a time-limited, closely monitored trial.”

Cover the rationale, briefly:
“A pilot study of liraglutide in people with obesity and frequent or chronic migraine showed fewer headache days, with minimal weight change, which suggests a brain effect, not just weight loss [1]. I know confirmation studies are needed [2,3].”

Ask the key safety questions:
“Given my history and meds, are there reasons a GLP-1 would be risky for me? Do I need baseline labs like A1c, kidney and liver function? What red flags should trigger stopping?”

Agree on the plan, not just the prescription:
“Can we set clear metrics, like tracking monthly headache days and disability, and decide in 4–12 weeks whether to continue, adjust dose, or stop?”

What to expect and how to prepare

Most clinicians reassess response between 4 and 12 weeks. Early side effects are usually gastrointestinal, such as nausea or constipation; hydration, slower titration, and regular meals often help. Headache can paradoxically flare during initiation; report any worsening, and especially any neurologic changes [1,4,5].

Safety snapshot you can read out loud

“These medicines are not approved for migraine. Common side effects are GI. Rare events exist. There’s a published case report of worsening hemiplegic migraine on a GLP-1 that improved after stopping, so complex subtypes may need specialist input [4]. We’ll pause or stop if red flags appear.”

How to fit GLP-1 into a broader plan

Position GLP-1 as an add-on, not a replacement. Keep any preventive that helps. Keep acute meds that are effective and safe. Track outcomes weekly with the same simple metrics. The goal is fewer, shorter, less intense attacks, not perfection [2,3].

How to get GLP-1 care with Well Revolution

1. Start a visit: Share your migraine history, prior treatments, conditions, and current meds.
2. Clinical review: A clinician screens for red flags, interactions and may order baseline labs to check GLP-1 suitability.
3. Shared decision: If appropriate for your metabolic health, discuss an off-label, time-limited GLP-1 trial with a headache-tracking plan and a 4–12 week check-in.

Learn more how to get GLP-1 care with Well Revolution here.

Outlook

If larger randomized trials confirm these findings and clarify safety, GLP-1s could become a useful preventive option for a subset of people with migraine, especially those with coexisting obesity or diabetes. For now, treat them as a credible, investigational path that deserves careful, individualized oversight.  

Health concerns, no matter how minor they may seem, can severely impact your overall well-being and quality of life. If you're experiencing symptoms or have concerns about a specific health condition, remember that timely and expert advice is key. Navigating healthcare can be challenging, but finding the right primary care physician shouldn't be. Whether you're seeking medical advice, a prescription or care, immediate access to expert primary care is just a button away. Don’t leave your health to chance - consult a Well Revolution primary care provider today for peace of mind and professional care.

References

• Braca S, Russo CV, Stornaiuolo A, et al. Effectiveness and tolerability of liraglutide as add-on treatment in patients with obesity and high-frequency or chronic migraine: a prospective pilot study. Headache. 2025.  
• MedLink Neurology. From blood sugar to brain relief: GLP-1 therapy slashes migraine frequency. News release summarizing clinical signal, mechanisms, and next-step trials.  
• Northside Hospital News Center. GLP-1 drugs show promise for migraines, study finds. Study details, clinical caveats, and off-label context.  
• Modestino EJ, Bowirrat A, Lewandrowski KU, et al. Hemiplegic Migraines Exacerbated using an Injectable GLP-1 Agonist for Weight Loss. Acta Sci Neurol. 2024. Case report highlighting caution in neurologically complex migraine.  
• Torrance Bariatric Institute. Does GLP-1 Cause Headaches? What You Should Know. Practical guidance on early-phase headaches and when to seek help.