“Rapid relief” is a blessed phrase when it comes to migraine headaches, and it’s one that’s sometimes associated with gammaCore, a migraine device that has the potential to zap away symptoms in as little as 20 minutes. And yes, we do mean zap in a somewhat literal sense: The gammaCore Sapphire is a sleek-looking battery-powered device you apply to your neck to send mild electrical impulses to your brain, which, in basic terms, tells it to stop making your head hurt so much.
It’s not the only device of its kind: Other migraine devices you may have heard of like Nerivio and Cefaly also use electrical signals to relieve migraine symptoms. But depending on your medical history and personal preferences, gammaCore may be an option.
What is gammaCore?
GammaCore is a migraine device that stimulates the vagus nerve, which is located in the neck, through the delivery of gentle electrical pulses. While some vagus nerve stimulators are surgically implanted—such as those that treat epilepsy and depression—gammaCore comes in the form of a small, hand-held device, making it less invasive.
How does gammaCore work to treat migraine headaches?
Understanding the function of the vagus nerve is key to understanding how gammaCore works: The vagus nerve is part of the parasympathetic nervous system, and it’s one of the vital connections between the brain and your gastrointestinal tract. In other words, it sends information from your gut to your brain, and vice versa.
So what does your vagus nerve have to do with migraine headaches? Well, research shows that the nerve may have the ability to influence the head pain pathways in the brain. Stimulating the nerve can suppress the brain activity that leads to migraine headaches. And it can work pretty quickly: Each gammaCore treatment consists of two 2-minute sessions—one for each side of the neck—and you can expect to experience some relief within 20 to 30 minutes, and to be pain-free about two hours after administering the first treatment. If the pain hasn’t diminished, you can administer a third treatment. And if your symptoms keep cropping up (ugh), you can use gammaCore for up to four attacks a day.
Is gammaCore proven to work?
Yes. The FDA approved gammaCore in 2017, following clinical trials that demonstrated that the treatment was safe and more effective than a placebo. A February 2020 study published in the American Journal of Managed Care found that “most attacks resulted in improved pain levels” when participants used gammaCore. Out of the 116 migraine attacks treated with the device, 70 percent of them diminished completely within 30 minutes or were described as being mild.
In January 2022, a study published in Cephalalgia suggested that "non-invasive vagus nerve stimulation" (what gammaCore does) may be effective for migraine prevention as well.
How do I know if I should try gammaCore?
You shouldn’t try gammaCore if you have an implantable medical device like a pacemaker, or a surgically-implanted hearing aid. People who have implanted metallic devices (like bone screws or bone plates) shouldn’t use gammaCore either, according to its site. And unfortunately, researchers haven’t yet investigated whether the treatment is effective for pregnant women, pediatric patients, patients who’ve had surgery on their vagus nerve, patients with carotid atherosclerosis, or patients with certain blood pressure and heart problems, nor has it been shown to be effective for people with chronic—rather than episodic—cluster headaches.
If none of these apply to you, gammaCore may be worth a try, especially if you’ve already tried injectable or pill-based medications to treat migraine attacks and found it inconvenient, or experienced unwanted side effects. Of course, it’s always best to talk to your doctor about what’s right for you.
Does gammaCore require a prescription?
Yes, gammaCore is a prescription-only device. After your first prescription you’ll receive refill cards in the mail that the device must scan before being ready for use. Each prescription lasts 31 days.
Are there any gammaCore side effects?
Most people experience muscle contractions while administering gammaCore, but they shouldn’t be painful. (If they do get too uncomfortable, you can lower the intensity of the electrical pulses, reposition the device, or turn it off.) Participants in the study published in the American Journal of Managed Care also reported the following side effects:
- chest tightness
- feeling hot or cold
- feeling weak
- nausea and/or vomiting
- pressure or heavy-feeling parts of the body
And the FDA has reported side effects like tingling at the treatment site, skin irritation, fainting, fatigue, a depressed mood, tinnitus, diarrhea, and abnormal heart rhythm, though they did not appear in studies of the treatment that were submitted to the FDA.
Shortness of breath, a change in voice, muscle twitching, and a change of taste were the most common side effects during FDA studies, but went away when the treatment session was complete.
How much does gammaCore cost?
It depends. While gammaCore costs about $598 per month out of pocket, they also offer a co-pay program for some patients that can reduce payments by $100 per month for up to a year.
What are other devices that treat migraine?
If you’ve been reading up on gammaCore, you’ve probably already heard of Nerivio or Cefaly, two migraine devices that also rely on nerve stimulation to treat attacks. Nerivio is a smartphone-controlled armband that, like gammaCore, uses electrical pulses to relieve migraine symptoms. Cefaly is applied directly to the forehead to stimulate the trigeminal nerve, which—in addition to treating active migraine attacks—can act preventively to reduce the frequency of migraine attacks as well as their intensity. The eNeura sTMS mini is another device that works preventively: Instead of targeting nerves in the neck, arm, or forehead, the eNeura sTMS mini is placed at the base of the skull.
GammaCore may not be right for you, be it because of pre-existing conditions or because of the price point. But don’t lose hope yet: There are a lot of new migraine devices and treatments out there, and more are being researched and developed all of the time. You can always talk to a Cove doctor about the right treatment plan for you based on your history and what you’ve already tried.
The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.
Photo by DAD via Death to Stock