Migraine prevention medications
 

I have had migraines for approx. 20 years. As I get older (I am 51) they seem to be getting worse and more frequent. I am on hormone replacement therapy so that should not be an issue.

My Dr put me in Inderal 40mg 2 x's a day about 4 months ago. The first 6 weeks or so it seemed to really help. Now not so much. I am also gaining weight. Ok, I know I'm in my 50's now but I've gained 6 pounds in as many weeks. :o I've cut back on junkfood, I do not drink sodas and I started exercising. I have never had a weight problem before.

Can anyone suggest another prevention med? I take Relpax when I get a migraine but my Ins. Co will only help pay for 8 tablets a month. I usually have 10-15 a month. I also have Phenagran or Zofran for the nausea.

Any other suggestions would be great too!

Thank you!

Migraine
 

I had migraines since my teens. Eventually went to a Neurologist that prescirbed the prevention meds. I was also prescribed Inderal; but along with the Inderal, I was prescribed Elavil. The two work together as a migraine preventative. I am surprised Elavil was not added to your Inderal.
This did help, along with some bio-feedback training for relaxation techniques.
They were helpful as well. This was some years ago.

I no longer get the migraines as frequent; but still do get at least once or twice a month. I take Imitrex. This has been the best aid to helping once the migraine has started. The sooner taken, the better. The doctor prescribes 50 mg tablets. They come in a quantity of 9 in a folder. I cut the 50 mgs in half, thus actually taking 25 mg's. The cost for the 50 mg's was the same as the cost for the 25 mg's. By getting the 50 mg's, cutting in half, I get a quantity of 18.

Hope this info will be of help. I cannot recommend the Imitrex highly enough. It has been a Godsend.

(ger)

Thank you for your reply! I used to take Imitrex but it stopped working for me. That is why I was switched to Relpax.

Is Elavil the same thing as Amitriptiline? If so, I'm allergic to it. Was on it for my Fibromyalgia a few years ago.

That is a great idea cutting the Imitrex in half!

Yes
 

Elavil is the same as Amitriptiline. Too bad Imitrex does not work for you. I used Midrin several years ago and just started the taking so much and then needing another. I forget the term at the time. I try to be sure I do not do that with the Imitrex. Otherwise, it will eventually cause "rebound" headaches. "Rebound" was the word I was looking for.

Not sure if this has anything to do with my headaches lessening; but after developing PN, I had Vallium added to my regimine of meds. Vallium is to help with anxiety, but also muscle problems. When I get a migraine, it usually would start on the left side; but the neck and shoulder muscle would also be involved. Since being on the Vallium (could be a coincidence) but headaches have lessened greatly. Again, also am careful not to take too many Imitrex as to not cause the "rebound" effect again, which just makes the headaches clear up for a short time and come back with a vengence.
Hope you are able to find something to help. These headaches can be so debilitating.
(Ger)

Not sure if this has anything to do with my headaches lessening; but after developing PN, I had Vallium added to my regimine of meds. Vallium is to help with anxiety, but also muscle problems. When I get a migraine, it usually would start on the left side; but the neck and shoulder muscle would also be involved. Since being on the Vallium (could be a coincidence) but headaches have lessened greatly. Again, also am careful not to take too many Imitrex as to not cause the "rebound" effect again, which just makes the headaches clear up for a short time and come back with a vengence.
Hope you are able to find something to help. These headaches can be so debilitating.
(Ger)[/QUOTE]

FWIW, vallium acts as a muscle relaxer too.

It's been a while since I was on prophylactics, so I don't recall them all off the top of my head. Try googling: migraine prophylaxis for a number of articles/POVs.

Also, I think it's worthwhile to find a migraine specialist - not just a neurologist or headache specialist - but one whose practice is limited solely to migraines. Finding the exact cause/reason can go a long way in finding the right/better meds (and possibly treatment/cure, though it's still rare). I suffered for many years and many neurologists until finding the "migraine guy" in my area. He was able to dx the type and cause of my migraines quickly, and while they're not "cured", they're substantially less than they were.

Doc

Migraines
 

Hello Im new here. You poor thing , I have suffered 22 years from these, Its debilitating,I understand. Ive used imitrex. and replax and sometimes they help not very well.So I usually end up taking narcotics beacuse the pain as you know is worse than horrible.Get back to me I care Catherine

Migraine Prevention
 

Hello- I just joined site this to address your post. *edit*

As you know, migraines are a chronic disabling disorder. Guidelines from the experts are clear that anyone with two or more debilitating headaches a month, as well as anyone with significant neurologic complications or a prolonged headache that responds poorly to acute treatment (like Imitrex, Relpax, etc) should be on preventive measures. Prevention is poorly encouraged!

*edit*

I always tell patients the ABCDEF- Apnea(sleep), biofeedback(relaxation), Caffeine (avoid), Diet (regular healthy eating), Exercise, and Fluids(>50 oz).
Often not discussed is the fact that several natural supplements are approved as level A recommended prevention choices. These include B2(riboflavin, Magnesium and Feverfew. THere is good data on Co Q 10 as well. I had compounded this through pharmacies for patients for years *edit* I will take off my salesman hat and suggest you review all information about prevention, from lifestyle to supplements to prescription meds through a doc. Getting comtrol of your migraines makes all the difference.

Stay well!

Hi there! I have been having migraines and bad headaches since I was a kid, I am now 45. I also am on hormone replacement therapy and have been since the age of 29, so that was never a cause of mine. A lot of people will say that they don't like Topamax, but it did wonders for me. I was on it for years and it cut my migraines down drastically. I was just taken off of it because it became ineffective, they tried Elavil but I couldn't tolerate it.

I have a baseline headache every day, have ever since I can remember. When it gets worse I take Fiorinal, when it is heading towards a migraine then I take Amerge. Amerge works incredibly for my migraines. I took pretty much all of the migraine meds and they did nothing - Zomig, Maxalt Relpax, every form of Imitrex, etc...Amerge is the only one that works for me!

Another thing that my Neurologist recommended is Butterbur, it's natural, and Magnesium. I have not tried them yet because I just got my first series of botox injections for my headaches/migraines. It is early to see if it is going to do the trick (been less than 2 wks), but I have not gotten an "ice-pick" headache since.

Good luck!!
Nanc

Hi Nanc,
 

Thanks for that list and experience.

My jaw kinda dropped :eek: when you said Dopamax-good/amitriptyline-bad, but I guess that just proves we're all different.

I'm in the tight spot of not being able to afford Maxalt anymore. When I began it, it was around $10/pill; now it's up to $26-$28/pill. Imitrex didn't work for me either, so I've got to find another affordable triptan (abortive). I wish Imitrex worked - it's generic now.

Doc

Hey Doc!
It is funny how we are all so different. I have so many allergies and intolerances which limits what I can take. Topamax was a Godsend for me for years, until my brain figured a way around it :(

Have you tired Amerge before? It comes in a generic form, naratriptan, which would cost less and it is just as effective (for me). I have been taking that one for a while too, NO side effects!! I can take it and still function, drive home from work...

It's worth checking out.
Nanc

Thanks, I did while reading your post. Wiki says it's not as effective as maxalt or imitrex, which gives me a little pause, but I've gotta find something soon. I've got a list going to discuss w/ my doc...

Doc

of course I meant "tried" not "tired" Amerge...

It's funny how Wiki says that Amerge is not as effective as Maxalt and Imitrex, when they did NOTHING for me at all. They didn't even take the edge off. A co-worker who suffers from migraines tried everything and Amerge is the only thing that helps her. She is the one who turned me on to it.

Anyway, I sure hope you find relief soon!!
Nanc

Hadn't even noticed. Dyslexics have more fnu. (I'm not - it's just a good moldie oldie... :D )

Yeah, but you also swear by Dopamax/Stupamax, which puts you in the minority; many/most cannot tolerate the S/E or the strain on kdneys/renal system.

I've seen enough differences/variation in folks' responses to meds/treatments that it's uncommon to phase me anymore. Less with every year.

Us weirdos gotta stick together. :rolleyes: :D

Doc

I get it! There are so few meds/treatments that I can tolerate that it was amazing that I found something(s) that actually worked. :eek:

Doc, your not as weird as you think. I can't tolerate anticonvulsants, tried altenolol and it wasn't preventing my migraines. I'm back on inderal and I'm having side effects that are not getting better so will be talking with doc at next visit about something else, if there is anything else, and I'm still tracking my headaches, with no success in finding a culprit. My rheumatologist says they can start at any time so theres no telling what the deal is with any of them, at least so I'm told. I had to beg my doc to stop altenolol and go back to inderal but the fatigue, numbness, increase in neuropathy pain, tightness in my chest, and my arms going number(er) is driving me nuts. I think the migraines drive me nuttier, but who knows at this point.:eek:

Wanna bet? :rolleyes:

I took atenelol for years because my insurance required it; didn't do a thing for me either. My migraines were finally tracked to reactivation of Epstein Barr virus, but it took finding a migraine specialist (that's all his practice consists of) to find that out.

I got some relief from the cervicogenic headaches with some physical therapy, but that took finding the right therapist who knew headaches as well (after various courses with other therapists).

I learned that general neuros & PTs just don't know enough, even though they think they do. Some can even be opthamological, though I don't know what a rheumy would have to do with migraines/headaches(?)

Have you got a good template for your journal/log? (Comprehensive enough?) Stick with it, expand the scope if necessary, and review it often. Something may jump out at you at some point, even if it only accounts for some it's worth it.

Doc

I was seeing my rheumy for something else and the subject was brought up by me, thats all. If all else fails with my current neuro who is a headache specialist, I may try to track down a migraine specialist if my insurance allows it.

Yes,
 

FWIW, vallium acts as a muscle relaxer too.[/QUOTE]

That is why I mentioned the Vallium is to help with anxiety; but also muscle problems.
(Ger)

Migraines - getting by on a prayer for now
 

Preventative medications do not work the same for everyone. It often takes a lot of trial and error to find the right one. I have been unsuccessful in finding a migraine preventative medication that doesn't cause intolerable side effects. I have been on topamax, inderol and lamictal. Couldn't tolerate the side effects of any of them so for now, I am dealing with the headaches as they come and taking a rescue medication as needed. Honestly, I am burnt out dealing with this health condition. It is really hard to accept that I have to live with it. I hope someday I can find something that will actually work to prevent the headaches that will also allow me to be functional. Side effects such as severe drowsiness, memory impairment, and diahrea are not what I would consider 'tolerable'. I could not continue to work and function while on these meds.

I will be starting a new job next week and I am fearful of how my employer will react when I miss work due to migraines. It's inevitable that absences will occur so I will have to tell my boss at some point. I will not be eligible to use FMLA protection until I have worked there for a year. I pray that the stress that comes with starting a new job will not trigger too many migraines. :smileypray:

Atenolol is another β-blocker you might ask your doctor about. I was on it for several years and experienced no side effects whatsoever.

Doc

I tried atenolol and it did nothing for me. My migraines continued as if I wasn't on any medication at all. It just goes to show how different we all react to different meds.

Not that different. Not only did I have no side efects, I had no other effects either, same as you. Finally (long story) I just stopped taking it. I still have migraines, but not as often as I did back then (no connection).

Doc

I was just prescribed a β-blocker today for migraine prevention (suffering since age 6, now 35 years of age). I've tried so many medications, and had many side effects (Elavil was dreadful, Neurontin was equally bad to me... Tegretol and another antidepressant were downright scary with side effects, can't recall which a/d it was).

Long story short, I just took my first dose of the β-blocker (Propranolol), so crossing my fingers this won't carry the side effects of the other medications I've tried. So far I just feel 'flush' or my heart feeling like it's beating a bit fast/occasional shortness of breath. Just need to remember not to stand up too quickly, I already have low blood pressure, and this lowers it even more.

*Edit: the flush/heartbeat/breath thing was short-lived, only a second or 2 at most. So far so good!

Sorry you had a bad experience with amitriptyline (Elavil). I'm thinking about asking for it again to help with sleeping w/ chronic pain. It's a low dose for that - 25 mg IIRC. Do you recall the dosage for migraine prophylaxis and the S/E you experienced?

From some reading I've been doing lately, I'm wondering if those years on atenolol may have been a contributing factor in my PN. :Hum:

Might be prudent to read up on the propranolol! :Clever:

Doc

FWIW, I'm using propanolol. I started with 20mg twice daily and I was too drowsy but I'm on a lot of meds that cause drowsiness so it doesn't take much to make it worse. I was still getting migraines, but not too often. I did have to reduce my dose to 10mg twice daily and I feel as though I'm on the verge of getting a MH a lot of the time and I'm still getting them, but the drowsiness for me is a little more manageable. Its a fine line between the right dose and too much, for me, but the drug is helping control the MH's so I'm staying on it. I'm new to MH so my experience is limited here. I do hope it helps you.

Take care, ee

Ironically, I took only 2 doses 20mg each of Propranolol. I did not sleep at ALL the first night. Every 10-15 minutes I was out of sleep. It was unreal.

Why did I stop though? With my MS, I spoke to my neurologist who ordered me into the hospital. After a 7 hour wait at the ER, I was put on an IV with migraine meds (he wanted to rule out possible MS relapse versus migraine) and then suggested stopping the propranolol and instead trying Topiramate.

I'd taken Topiramate a long time back, but don't recall side effects of the medication, so I'm hoping this will help. Though now I'm even questioning if I truly am suffering migraine or cluster/tension headaches (or the MS). I had all that IV medication last night, yet I have the same symptoms today (less pain however, and taking a Tylenol with codeine resolved the headache, though the banding feeling over my nose and pressure in sinus is back).

As for Amitriptyline and the side effects I had.....

- dry mouth
- receeding gums (probably due to the dry mouth)
- spots on the skin (across my breast bone)
- nightmares
- bed wetting
- forgetting to eat
- extremely low blood pressure (almost fainted dozens of times)
- blurred vision (though this was questionably my MS too)
- sexual function changes

(referenced Wikipedia for some. Others I remember from having, but I stopped taking it 3-4 years ago so it's difficult to remember, I've been through a few medications!)

Prevention guidelines updated in April 2012
 

Do a quick good search for the recently updated American Academy of Neurology guidleines for prevention. There are many prescription medications as well as supplements that can have equally beneficial effects. Sometimes a combination of supplements- particularly invluding magnesium, robiflavin and feverfew- can be very safe and useful. Prescription meds can be added but there are many approved so dont feel copnstrained to just a couple options. Print out and discuss the new guidelines with your doc to find effective options.
Best wishes: Migraine-Away

Migraine prophylactics
 

My MD is putting me on Keppra (levetiracetam). The Keppra is supposed to be similar to lyrica and lamictal. Lyrica was helping with my migraines. It was immediate noticeable difference. But it made me too tired to function at work. Lamictal caused daily headaches and horrible fatigue while I was on it. If Keppra doesn't work, we may try atenolol or elavil next.

I just need some relief. I've been so sick the past couple weeks I can't take it anymore. The extreme heat this summer has devasted me in terms of the migraines. I'm scared I won't make it through to many more trials and may not be able to continue working. I am extremely worn down from all the ongoing health issues of the past couple years. I have no family near by, no real support system. Yes I have friends but no one is in a position to really help when I need it. They are so wrapped up in their own lives and trying to hang on to their own jobs that they do not offer or cannot offer help when it's needed. I'm really on my own. I broke down and started crying in the doctor's office a few days ago. He asked, "don't you have family that can help out?" I know I'm not the only person in a predicament like this. I don't know what other people do to get by when their health gets this bad and there is no support. There just anywhere for people like me to turn to.

I go to my new pain management doctor tomorrow. We will be discussing the option of radiofrequency ablasion for my neck pain.

I can suggest a couple of things. I can't make any promises, but it can't hurt to try...

Check with your doctors and/or local hospitals for support groups for migraines or the other health issues you have. Support is there, and friends are made quickly, but use common sense/caution and take it slow.

Many communities have 211 (like dialing 911) for information & referral of services. They may also have information on local support groups or other services available.

http://www.211.org/

Try google for support groups local to yourself, or information on how to start one. Lack of an existing group doesn't indicate that there isn't need or desire.

Doc

I have been taking Topomax recently as a preventative and so far so good. My only complaint is that it makes soda taste awful! I've been getting migraines since I was 12. I hope you can find what works for you.

topomax for my migranes
 

[QUOTE=Peaceful1tou;859160]I have had migraines for approx. 20 years. As I get older (I am 51) they seem to be getting worse and more frequent. I am on hormone replacement therapy so that should not be an issue.

My Dr put me in Inderal 40mg 2 x's a day about 4 months ago. The first 6 weeks or so it seemed to really help. Now not so much. I am also gaining weight. Ok, I know I'm in my 50's now but I've gained 6 pounds in as many weeks. :o I've cut back on junkfood, I do not drink sodas and I started exercising. I have never had a weight problem before.

Can anyone suggest another prevention med? I take Relpax when I get a migraine but my Ins. Co will only help pay for 8 tablets a month. I usually have 10-15 a month. I also have Phenagran or Zofran for the nausea.

Any other suggestions would be great too!

Hi, sorry about your headaches and lousy insurance restrictions.
I have PCS and have been on topomax over 2 1/2 years for my migranes and it has helped me tremendously. I don't think I have any side effects from it. I have other problems that are not great, not related to med, I hope.

Thank you

Me too, and my they taste absolutely foul now lol :P

I must say at first Topamax kicked my *** so bad, I'd get everything there was supposed to be a side effect ugh, but in the second month it all started to pick up.

The one thing is that I still get a very rare migraine like once a month but that's because I'm under the most unhealthy horrible stressful situation of my life, my doctor is just very concerned but we're taking it as we go.

What about an alternative to drugs?

There is a lot of evidence to say that a magnesium supplement can be a successful treatment for migraine. Just look on the internet. Try also Dr Carolyn Jones.

If you google: migraine prophylaxis, you'll get hits for medications, supplements, and other means of preventing migraine.

Doc