Potential role of tirzepatide, a dual GLP-1 and GIP receptor agonist, for preventive treatment of migraine: A case series.

BACKGROUND: Obesity is a known comorbidity of migraine that can increase attack frequency and severity and lead to disease chronification. Glucagon-like peptide-1 (GLP-1) receptor agonists and related medications have demonstrated benefits beyond glycemic control and weight management, with emerging evidence suggesting a potential role in pain modulation. Clinical observations have also suggested the role of GLP-1 based therapies for the treatment of idiopathic intracranial hypertension, but their role in migraine has not been established. CASE SERIES: Here, we report two cases of patients with migraine who experienced a reduction in migraine headache frequency following initiation of tirzepatide, a dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonist. DISCUSSION: These cases suggest that GLP-1 receptor agonists and dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonists may have potential therapeutic relevance in migraine management. Notably, both patients experienced weight loss with treatment, which represents a significant confounding factor that limits conclusions about a direct migraine-specific effect. These cases should be interpreted as preliminary observations. Future studies evaluating migraine outcomes in patients treated with these medications are needed to better understand the underlying mechanism and explore their potential role as novel therapeutic pathways for migraine.