IN NAD, Migraine Headaches and Anxiety Disorders: A Case Report

Intranasal Administration of Nicotinamide Adenine Dinucleotide Alleviates Headaches Associated with Migraine Pain and Reduces Adverse Effects of Anxiety Disorders: A Case Report


1NAD Research, Inc., Springfield, LA; 2Podesta Wellness, Tulane Clin. Fac., New Orleans, LA; 3William Carey Univ., Hattiesburg, MS; 4Springfield Wellness Ctr., Springfield, LA

Braidy, N., Berg, J., Clement, J., Khorshidi, F., Poljak, A., Jayasena, T., Grant, R., Sachdev, P. (2019). Role of nicotinamide adenine dinucleotide and related precursors as therapeutic targets for age-related degenerative diseases: Rationale, biochemistry, pharmacokinetics, and outcomes. Antioxid Redox Signal, 30(2), 251-294. doi: 10.1089/ars.2017.7269

Lautrup, S., Sinclair, D. A., Mattson, M. P., & Fang, E. F. (2019). NAD + in brain aging and neurodegenerative disorders. Cell Metabolism30(4), 630–655.

Ross Grant, Jade Berg, Richard Mestayer, Nady Braidy, James Bennett, Susan Broom, & James Watson. (2019). A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD+. Frontiers in Aging Neuroscience11.

Gilmour BC, Gudmundsrud R, Frank J, Hov A, Lautrup S, Aman Y, Røsjø H, Brenner C, Ziegler M, Tysnes OB, Tzoulis C, Omland T, Søraas A, Holmøy T, Bergersen LH, Storm-Mathisen J, Nilsen H, Fang EF. Targeting NAD+ in translational research to relieve diseases and conditions of metabolic stress and aging. Mech Ageing Dev. 2020 Mar;186:111208. doi: 10.1016/j.mad.2020.111208. Epub 2020 Jan 15. PMID: 31953124.

Figure 1. Technique of intranasal sphenopalatine ganglion block. Reproduced under Open Access charter from: Forrest A, Cantos A, Butani D. How We Do It: Sphenopalatine Ganglion Blockade for Migraine Treatment. Available from: American Journal of Interventional Radiology ( 

Figure 1. License: This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License (, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. 

Case report presented at the Society for Neuroscience, San Diego, CA, in November 2022

Intranasal administration of nicotinamide adenine dinucleotide alleviates headaches associated with migraine headache pain and reduces adverse effects of anxiety disorders: A case report

*J. WHITE1, A. PODESTA2, G. A. DYESS1, S. L. BROOM1,3, R. F. MESTAYER1. Intranasal administration of nicotinamide adenine dinucleotide alleviates headaches associated with migraine headache pain and reduces adverse effects of anxiety disorders: A case report.

  1. NAD Research Inc., Springfield, Louisiana, 2. Podesta Wellness, Tulane Clinical Faculty, New Orleans, Louisiana 3. William Carey University, Hattiesburg, MS.


Research suggests that Nicotinamide Adenine Dinucleotide (NAD+) is effective in treating clinical conditions associated with disease and aging due to its vital role in healthy cell functioning.  Clinicians around the U.S. developed intranasal (IN) NAD+ administration protocols directly on the sphenopalatine ganglion (SPG) for migraine/cluster headaches and symptoms associated with anxiety.  This case report describes a patient response to IN NAD+ experiencing symptoms associated with migraine headache, Agoraphobia, PTSD, and severe anxiety.


A 55-year-old male patient presented with disabling PTSD with paranoia, bipolar traits, and migraine/cluster headaches poorly controlled by traditional medications. Patient reported frequent panic attacks, debilitating headaches, anxiety with Agoraphobia, and history of attempted suicide. On 2/07/2020 the patient scored 27 on the Warwick-Edinburg Mental Well-being Scale (WEMWBS). Patient received NAD+ (0.375ml of 100mg/ml) and lidocaine (0.25ml of 20mg/1ml) into each nostril via sphenocatheter followed up by treatments at 1 and 4 weeksAdditional outcome measures were collected at 2m, 8m, and 1-year.


After the first session, patient reported needing less migraine medication and improved sleep.  After 3 days, patient reported less intense panic attacks during the day and cessation of nightly panic attacks. At 1 month, patient reported mild headaches and was able to taper off quetiapine and oxcarbazepine.  Between 1 and 4-weeks, he reported 2 cluster headaches while no longer taking sumatriptan or requiring oxygen. On 3/15/2020, the patient scored 45 on the WEMWBS, showing significant improvement despite being on less medication. At 1-year follow-up, patient reported reoccurrence of nightmares, but not needing rescue medications or oxygen.


The mechanism of action for IN NAD+ application is unclear; however, data suggest that delivery directly on SPG facilitates the attenuation of migraine/cluster headaches and anxiety symptoms beyond medication therapy alone, with fewer side effects. NAD+ efficacy lessened over the extended break in treatment due to the COVID-19 pandemic, however significant dampening in symptoms was rapidly (< 4 days) observed, despite taking less medication.


Data show a rapid and sustained treatment effect of decreased severity and alleviation of migraine pain and anxiety symptoms resulted in enhanced quality of life measures and less need for medications to manage symptoms. Further studies are warranted to empirically validate NAD+ as an alternative or augmenting treatment approach in a subset of clinical populations.

Key words


Theme D: Sensory Systems

D.02.b. Headache, migraine. and trigeminal circuits

D.02.l. Non-opioid treatments


Theme G: Motivation and Emotion

G.06. Anxiety Disorders

G.06.a. Human studies and therapeutic approaches