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A class of medications used normally for treating migraine headaches is making headlines this month as new research seems to suggest they might also suppress appetite, and have effects on weight loss.
So could we see migraine drugs being used for weight loss in the future? Here’s why I wouldn’t hold my breath about it.
How triptans work
Triptans are a class of medications normally used for migraine headaches. They work by stimulating serotonin receptors in the brain. What this does for migraines, is help to modulate blood flow in the brain, and reduce the sensation of pain from migraines and cluster headaches.
We also know that serotonin plays a role in regulating mood and appetite in our bodies, and stimulating serotonin can help control some of those functions.
The triptans stimulate a specific kind of serotonin receptor called 5HT-1B, and this receptor is what researchers believe might have some effect on appetite.
Researching triptans for weight loss
Research on mice
So researchers decided to test it, and gave one group of mice one of six different triptan medications, and the other group was given no medication.
They then fed both groups a high fat diet, and found that the group given one of the triptan medications called frovatriptan over 24 days, had lost on average, 3.6% of their body weight, while mice not given frovatriptan gained an average of 5.1%. So that’s a comparative weight difference of 8.7% body weight.
The researchers then engineered some mice to not have the specific 5HT-1B serotonin receptor, and found that giving these mice frovatriptan had no effect on weight, helping to confirm that it is this receptor that was causing the weight loss.
Reusing old drugs for weight loss
The implication was that this serotonin receptor could be stimulated to help reduce appetite, and that existing medications that already stimulated this receptor, like the triptans, could be repurposed for use in weight loss in the future.
Repurposing old drugs for weight loss is not a new concept. With the recent wave of repurposing diabetes medication like semaglutide for weight loss being so lucrative, it’s not surprising to see a lot of additional research into existing drugs, to see if they might have any weight loss potential.
Semaglutide started its life as a medication for diabetes under the brand name Ozempic. Once Novo Nordisk found out it could also cause weight loss, they jacked up the dose and rebranded it under the name Wegovy.
It’s now one of the company’s biggest moneymakers, and they’re about to do the same thing to another diabetes drug called Rybelsus, which is actually also semaglutide, just in a pill form, rather than being injected.
Serotonin and appetite suppression
Stimulating serotonin for weight loss is an interesting target since serotonin does quite a lot of things in the body. There are serotonin receptors all over our body, and it performs so many different functions that I’m not going to bother trying to go through it all here, there are just too many.
It’s known as the “feel good” chemical since it’s often used in a lot of processes that involve pleasurable or happy things.
Stimulating serotonin could help patients feel more full and satisfied with less food, or not need to succumb to food for pleasure as often, like in stress eating.
We actually know of other drugs that target serotonin receptors that have strong weight loss effects by suppressing appetite. Some examples include lorcaserin (Belviq), sibutramine (Meridia), and the combination fenfluramine and phentermine (fen-phen).
Unfortunately, these weight loss drugs cause other serious health issues, with two of them potentially causing fatal heart issues, and one of them potentially causing cancer, leading to them all eventually being banned in North America.
As a side note, it’s hard to say whether some of these drugs actually deserved a ban, since we see these types of serious side effects from other non-banned weight loss drugs, nevertheless stimulating serotonin for weight loss can be a dangerous game. We know that it can sometimes help with weight loss, but it’s also found nearly everywhere else in the body. You just never know what else you’re going to be stimulating.
Now there are many different types of serotonin receptors, so not all drugs that stimulate serotonin will cause these problems. Researchers look to specifically target one or two types of serotonin receptors to more focus their effects.
Researchers in this study were hoping to look at other, safer drugs, like frovatriptan, that stimulate the specific serotonin receptor 5HT-1B, to see if it would help to regulate appetite.
Natural ways to stimulate serotonin
So if stimulating serotonin might help with mood and appetite, are there natural ways to increase serotonin in your body?
There are! Exercise is one way some people are able to boost serotonin levels.
The best effects are seen when people exercise regularly, and undertake aerobic exercise at a level with which they are comfortable with. So any sort of physical activity that gets your heart rate up and most importantly that you enjoy, like gardening, cycling, swimming, or walking the dog, should help increase serotonin levels and also burn calories.
Certain foods like eggs, cheese, milk and dairy can help support healthy serotonin levels on a weight loss diet.
These foods are high in an essential amino acid called tryptophan, which is used to make serotonin in your body, and providing more of this building block can help your body to produce more serotonin as it needs it. Protein sources like turkey, chicken, tuna, nuts and seeds are also great sources of tryptophan on your diet.
However, it’s important to note that increasing serotonin levels from the diet is a little more complicated.
The reason is because tryptophan doesn’t get absorbed too well in the presence of other amino acids, and because these protein-rich foods are composed of many other types of amino acids, your body doesn’t usually end up absorbing a whole lot of tryptophan from these foods.
So simply put, eating these foods may not necessarily boost your serotonin levels higher, but rather support the natural production of serotonin.
At the end of the day, the most we can really say right now about this research is that this migraine medication might be slightly useful for weight loss in obese mice.
Triptans for weight loss?
Unfortunately, we are likely far away from seeing migraine medication for weight loss.
Firstly, this study was just in mice, and it still has a while to go before we even consider testing it in humans for weight loss.
Also, frovatriptan’s effects on weight are pretty small, with only a 3.6% weight loss in a month. Most weight loss medications sit in the 5 to 20% weight loss range, and even orlistat is expected to help with around 5% weight loss without the need to deal with side effects like dizziness, chest pain, or potentially serious heart problems.
A review of frovatriptan’s side effects also shows that weight loss or appetite suppression are not common side effects of taking this medication. So it’s possible that although frovatriptan causes weight loss in mice, we probably won’t see this effect in humans.
In fact, the only research I could find on frovatriptan’s ability to help with weight loss in humans, are studies that found that obese adolescent migraine sufferers experienced some weight loss when their headaches improved while on the medication.
So I guess if you suffered from migraines, frovatriptan might help you lose some weight, although it might also be the relief of migraines and resulting improved mood that was the larger driving force for weight loss, rather than medication itself.
I mean there are definitely medications used for migraines that might cause weight gain, like amitriptyline and divalproex sodium, so I suppose that the triptans offer a weight neutral option for migraine sufferers.
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Citations
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