Hi - We are definitely here for you and have been through a lot of what you describe- though it sounds your case was made more complicated by that diagnosis. So sorry to hear that. Please do take a look at the link that Cody provided above. There are a lot of good insights there as well as strategies to regrow hair (biotin is a big helper on this front if you haven't tried it yet). I know you said you wanted to keep the conversation a medication discussion- which I didn't quite follow as I consider Botox to be one of my key migraine medication strategies. Perhaps just a tangle in wording. I've been taking it for 20 years and it hasn't caused any hair loss. I have taken topiramate and steroids for migraine which have caused hair loss. The CGRP family of meds have not caused hair loss for me - but truly the side effects - while troublesome for some- are not a given for all. This is what's tricky.
You are I are similar in age and I think by now in our lives we come to know what are our hair loss triggers, generally. For me, my primary hair loss trigger is extreme stress. When I'm on a medication (like topamax or steroids) that hair loss is ramped up severely if I have a major life stressor. I think this is due to the way our adrenals connect to stress and hair growth. Thankfully it eventually grows back but it is awful to go through and takes forever. I guess all this to say, there are many different types of CGRP (and general) migraine treatments. We all respond differently to them. So, if you are open to a trial period of the qulipta, perhaps you won't experience hair loss. If you'd rather not risk it, perhaps you may want to explore one of the CGRP options with your doctor. But as you said, if you research deep enough, you'll likely find someone somewhere who will assign hair loss to any drug. I've taken Emgality for years without an issue. But again, you'd probably find others who may say they had hair loss as a result of it. I'm sorry I can't be more helpful- it is a dreadful part of trying new medications. Even worse when we find a medication that works which presents with a troublesome side effect like this. We have to decide between the migraine pain and related symptoms- or hair loss or weight gain, etc. No easy choices. Please know we are here for you as you continue this journey and weigh your options. Thinking of you- Warmly - Holly - migraine.com team