Nerivio, a drug-free treatment for acute migraines

Nerivio is a smartphone-controlled wireless device that provides electrical stimulation of the type that is similar to TENS units widely used in physical therapy for musculoskeletal disorders. It was approved by the FDA last year for the treatment of acute migraines.

Nerivio was proven to be effective in a double-blind, sham-controlled study of 252 adults with migraine headaches. It was applied for 40 minutes on the upper arm and the strength of the current is gradually increased to a strong but non-painful intensity level. Active stimulation was more effective than sham stimulation in achieving pain relief (67% vs 39%), pain-free state (37% vs 18%), and relief of the most bothersome symptom such as nausea sensitivity to light or noise (46% vs 22%) at 2 hours post-treatment. The pain relief and pain-free superiority of the active treatment was sustained 48 hours post-treatment. The device was very well tolerated with only a few patients reporting local irritation.

This device is controlled by a smartphone which allows the manufacturer to collect data about its use (with patients’ permission and without identifying individual patients). After 6 months of my prescribing this device to a couple of hundred of patients, 62% of my patients reported having pain relief after 2 hours and 24% reported to be pain free after 2 hours. These numbers are comparable to the results seen with migraine drugs such as triptans (sumatriptan or Imitrex and other) as well as the new class of abortive migraine drugs, gepants (ubrogepant or Ubrelvy and rimegepant or Nurtec ODT). One big advantage of Nerivio is that it is not ingested and is much less likely to cause any side effects.

Theranica, the manufacturer of Nerivio is working to expand the indications for the device by conducting trials in adolescents and patients with chronic migraines.

Nerivio is not covered by most insurance companies and costs $99 for each disposable device which provides 12 treatments. It is available only by prescription. If you have difficulty finding a headache specialist, since the start of the pandemic we have begun to offer telemedicine visits using HIPAA-compliant platform. You can call our front desk (212-794-3550) to schedule an appointment.