Dr. Roger Cady Recognized for Contribution to Migraine Medicine

Lundbeck’s Roger Cady, MD, vice president of Neurology, was recently honored with the National Headache Foundation’s Special Lifetime Achievement in Primary Care Headache Medicine. Dr. Cady has dedicated his entire professional career to supporting people with migraine and expanding understanding of the disease. He graduated from the Mayo Medical School and completed his residency in family medicine. Over the next several decades, he pioneered an inter-disciplinary care model for managing patients living with migraine and, through extensive clinical research, established himself as a key thought leader in the medical specialty of headache. He joined Lundbeck in 2019.

He recently shared with us why he specialized in migraine and his hopes for the future of migraine medicine.

Q: How did you come to specialize in migraine care?
Dr. Cady: Like many people in this field, I grew up in a migraine family. In those days, that was back in the 1950s, migraine really wasn’t considered a disease. People thought they had a sinus infection or it was stress, but rarely was it migraine. And that was true in my family. My mother, looking back, was clearly a person with chronic migraine. But all of her adult life, she thought she had sinus disease. She went to ENT doctors and had surgery and took sinus medicine, none of which provided much benefit. It gave me an appreciation for what migraine really was, and that it was really something much more than simply a headache. When I went to medical school, it was important for me to take migraine seriously and develop a better understanding of it.

Q: How has treatment of migraine disease changed over the course of your career?
Dr. Cady: When I started in migraine, it was often considered a consequence of “wrong” living rather than a disease. With the advent of triptan drugs [a class of drugs used in the treatment of migraine], migraine became to be viewed as an episodic disorder and treatment focused on treating attacks.

What has really transformed in the last decade is an understanding that there is a disease that underpins these attacks of migraine. People with migraine are born with a unique nervous system, and when that nervous system is exposed to frequent attacks of migraine, it can sensitize the nervous system, causing some people to experience more frequent attacks of migraine until the disease is present nearly all the time. This is called chronic migraine.

Understanding this disease model of migraine has been very important because it changed [the approach] to one of preventing migraine. Also with that understanding, it became paramount to protect, rather than rescue the nervous system from migraine.

Q: Why did you decide to transition from your clinical practice to industry? 
Dr. Cady: In clinical practice, you treat patients one at a time. I always felt that in industry you could look at large number of patients and this might accelerate what we can learn. And there’s such a large population of people with migraine that maybe from a higher level that in industry, we could do more and help more people.

Q: What has been the most rewarding aspect of working with the migraine community?
Dr. Cady: What I find so rewarding is the opportunity to make a meaningful difference in the lives of so many people living with migraine. Migraine impacts virtually every domain of a person’s life. It can impact their health, choices for professional pursuits, families, social interactions and careers. Migraine can, and often does, become a chronic disease associated with many co-morbidities like depression and anxiety. 

It is my dream that in the future, with good science, we will modify and reverse migraine disease and give back to people the life they want and deserve.