An update on the Nerivio device
It’s been a year since the introduction of Nerivio, an electrical stimulation device for the acute treatment of migraines. One of the unique features of the device is that it is controlled by a smartphone app. This allows Theranica, the manufacturer of Nerivio, to collect data on its use. They just published real-world data on the use of Nerivio in the first 6 months after its introduction.
59% or 662 out of 1,123 patients treated by headache specialists and 74% or 23 out of 31 patients treated by non-headache specialists reported pain relief at two hours in at least half of their treated attacks. Complete pain freedom was achieved by 20% of the patients in the first group and 36% in the second group in at least half of their treated attacks. Only 0.5% of the patients reported device-related adverse events.
The number of patients treated by non-headache specialists is small. Nevertheless, because headache specialists tend to see patients who are more severely affected by their migraines, it is likely that the device will be more effective in the hands of non-headache specialists, or rather on the arms of patients treated by such doctors. Nerivio is a disposable device that is placed on the upper arm for 45 minutes.
My subjective impression correlates with this published data. Some of my patients use it along with their abortive medications such as triptans or NSAIDs. One patient finds that the stimulation not only relieves pain but is also very relaxing. Even though you can continue your normal activities, I recommend that patients try to relax or meditate during this treatment. The advantage of Nerivio is that is a drug-free treatment and is very safe. People who find Nerivio particularly appealing are those who have side effects from drugs, have multiple allergies, pregnant or nursing, and for whom drugs are ineffective.
Nerivio is available by prescription from your healthcare provider, by consulting (virtually or in-person) one of our headache specialists, or by connecting to a doctor on Cove, a telemedicine startup.
Disclosures: I have provided consulting services to both Theranica and Cove.
There is no way to predict who will respond to Nerivio. It is always trial and error. Some patients use it to enhance the effect of the triptan or instead of it.
Is there any information or do you have any “subjective impressions” on which types of migraines this device is effective for? (Is there any hopes to classify migraines better than the current 3-4 categories?)
I guess a more specific question would be: do you have any indication that his might help a patient that generally finds relief with a triptan, but that sometimes has headaches that don’t fully go away with the usual triptan dose?