Migraines - starting Gabapentin for now, seeking neuro asap
 

Well.

My stomach has revolted violently against further use of NSAIDs. I am going to do a 6-8 week diet to try to let my GI tract recover. This means no NSAIDs and there went my migraine medication.

In any case i've been having so many i had to "pick my battles" as far as medication - I really need a prophylactic, andi need a neuro, and an exemption so hopefully i won't have to keep shelling out for the meds.

Gabapentin has worked in the past as a prophylactic. I started it today - i had a moderate headache. I didn't expect it but it apparently worked directly... that or the migraine coincidentally ended.

In any case, i am ramping up Gabapentin for migraine prevention to 1200mg.

Tomorrow i will try to book the neuro i wanted but if he doesn't have anything soon, i'll call around. a lot of what i need is paperwork signed and stamped, plus some meds that aren't going to hurt my stomach. i'd like to try triptans.

~ waves ~ now losing it from a 3am dose of gabapentin. :Zzzz:

Dear Waves,

I hope that the Gabapentin helps you. Sleepy times might be in your future as your ramp up. :) ;)

Good luck dealing with the doc/s. :heartthrob:

M

Lol thanks Mari :D

Indeed, yesterday was like that... i was only going to do 2 300 mg doses spread apart... but after the first dose seemed to do amazing things with the migraine and neuralgia all down my neck... and since the headache reappeared about 6 hours after dosing, i took another 300 right then... kerflumppppp!!!

then i took 300 about 2 am...

today i have no headache, how nice, wow, wish i could take a picture of this feeling!

i have to get up to 4x300mg a day... i'm usually methodical with titration but i'm going to play it by ear ... if i start getting a headache i'll throw a full 300 dose at it, ramp or no ramp.

i was so amazed that it helped. it was not placebo effect... i could feel the drug in my whole body. my expectation was that it might make me sleepy but that it would take a while (weeks) in the system to help as a prophylactic. i just hope the results persist.

===========================
getting going on neuro...

mom just went to the nearby hospital (which i hate but through which i must have my exemption processed). She needed to book something for dad, so i gave her my referral to try to book me a neuro. worst case i will at least find out that my referral is expired. :rolleyes::cool:

i forgot to take down the referral number. when she gets back i'll call for an appt with the neruo my pdoc knows. Since he practises in a different area (health system) he probably can't do the exemption paperwork for me, but i'd like to see him first if possible. i can't do the exemption on the first visit anyway, so i could see him, then take the dx etc to the horrible hospital nearby.

Right then, here goes measuring out a 150 dose of gabapentin... lol fun fun fun. i have to eat the first half w/o capsule... yuck! :( it is very bitter! :o

~ waves ~

Good luck Waves

I think I've been on the Gabapentin for so long it doesn't work
on the migraines for me.

Donna:grouphug:

Thanks Donna,

sorry the gabapentin doesn't help you. i don't normally take it i guess that's why. when i took it for prophylaxis i was only on it for a year... then i stopped and my migraine frequency was back to 1-2 days a month, whew.

When i was having trouble at work with more migraines last year i tried it again but could not tolerate even 900mg d/t crazy side effects. I was on 1500mg of Depakote then and pdoc and i figured the combination of the two was too much. i hope that is the explanation, because....

I *REALLY* hope, now that i am back to 800mg Depakote, that i can tolerate a full 1200mg. That is the dose i found i needed for good coverage when i took it successfully as a prophylactic. (900 was not enough). Anyway and it's all i have available for now so it's worth a shot.

If it works, i'd expect to take it for a limited period - maybe a year. i know that its effects tend to poop out gradually if one stays on it.

~ waves ~

neuro update - temporary stall
 

Mom found out that my referral is no longer valid because the format has changed since its issue.

this means i can't make appointments today as i need a valid referral to do that.

:Sigh:

I can get that from my mdoc this evening. I need to see him for meds anyway, and ask if he might prescribe something to help my stomach recover from the recent NSAID-related insults and injuries.

~ waves ~

good luck with your mdoc today.
((((HUGS))))
bizi

Hi, Waves,

I am happy that the Gabapentin is helping.
You are making progress even if you encountered a stall. You are going through the process.

M

I'm so sorry you are having migraines. They are awful.
Perhaps I missed a post...but Topamax works very well to help prevent them.
And helps a little with BP Disorder.
Hang in there!

Hi Vowel Lady!
 

Thanks VL, :)

we'll see what the Neuro says... i am going to ask about the various options, and if he is reluctant to prescribe something i'll press to know the reasons why not.

Part of the reason too is that once i am used to it, i have no side effects from gabapentin (not case right now - still adjusting). Topamax is known to have some serious side effects. The last neuro refused to even let me try it; then again she was a real witch.

I also want to know if the state will pay for Topamax, coz it won't pay for gabapentin. Gabapentin may be cheap over there (?) but here it is expensive considering the amount i need.

However since gapapentin has worked before - and seems like it's helping even though i'm all groggy coz not used to it... many a doc would tell me to stay with that.

Nice to see you. I hope all is well with you and your family :hug::hug::hug:

~ waves ~ i'll have to reread this post tomorrow i hope it made sense i am falling asleep.

Dear Bizi
 

Mdoc went well - i got what i needed mostly. :)

Have neuro referral - will travel! :)

He fixed up my generic brands in his computer so we wouldn't have issues again, and was nice about it. He had given me the wrong generic for sertraline, and now they have to write "no substitution" on the script even for generics... so i couldn't get it filled! Also got some stuff fixed for dad, and he was nicer than i thought he would be about that.

He didn't know about migraine exemptions or if there were a way to get gabapentin put through the state even though he's supposed to know these things, since he's the point person for them. :o Well what can you do.

Mom checked when she was at the hospital the other day... The other GPs in our town are at their quota. Only ours is available (wonder why :rolleyes;) so can't even change right now.

Thanks so much for your support :):hug::hug::hug:

~ waves ~

Dear Mari
 

oh boy... so am I!!!!! i am in my pre-menstrual phase right now... i'd most likely be having migraine after migraine... judging by the "hints" of head pain i occasionally get on one side, then the other... but only subtle "hints" oh what a relief after that awful month almost non stop.... ackk!!!! :yikes:
Yes, I am going through the necessary steps.

I do rather feel as though i'm creeping forward ever so slowly, while the calendar is rearing up and slapping May in my face quite prematurely! :eek::Noooo:

i dropped the ball on fixing my resumes (2 languages). there is very little left to do so i am a bit disappointed i left it incomplete. And there's no excuse i do have the time and ample "consciousness-windows" to do it. There are indications that school and student i recently worked for will request some time. I'd rather give them second priority. I want part-time employment but preferably with a dedicated language school. Hence my urgency to have materials ready to be "fired out" as soon as i am well enough to take on interviewing.

Anyway. Yesterday morning i tried to call for an appointment at the clinic, but the call center was O/O - "we invite you to call back later." LOL, "invite." i had to go to pdoc's so i suppose i declined their invitation. Today is a public holiday so 'twill have to wait till tomorrow.... sigh.

Heyyyy!!! can't call anyone or go anywhere today... perfect opportunity align those resume's eh? erhhemmm. :o:rolleyes::eek:

:Sigh:

=====================================
about gabapentin side effects - speech/cognition... :o

For the first time ever with gabapentin, when i most felt its effects, i had mild trouble with language - specifically
-- understanding normal-rapid speech (sounded like a rush of syllable salad)
-- replying to a question after a context switch
the last especially seems perhaps more of a general cognitive dulling thing.
but i was just wondering if you experienced either of these specifically.
example of the second one, is my parents were exchanging departure greetings - i was more or less following. my father turns to me and says what time do you have to leave. i say "da" (not meaning yes in russian, either! i look at the clock for help... by that time he has gone off to do something else.

ughhh.... scary.

:hug::hug::hug: I very much appreciate your being here for me.

~ waves ~

EVERYONE & Vowel Lady
 

Hi

EVERYONE:
sorry if i am replying out of order... last night Vowel Lady's colorful avatar caught my attention so i replied to her, LOL, but by the time i was done i was barely conscious - even took me a bit to find the submit button! :o:eek:


Vowel Lady:
my reply to you is on the previous page!


Thanks again to all of you for your support! :grouphug::heartthrob:

~ waves ~

Waves,

http://neurotalk.psychcentral.com/sh...=speech&page=2


I searched and this is what I found on my Gabapentin thread from July 5, 2011

+_+_+_+_+_+_+_+_+_+_+_+

I can't explain exactly what the speech issue is.
I've been home from work for two days so I can't remember.


+_+_+_+_+_++_+_+

Update today, April 25, 2012

I have to get ready for work. I can't spend time doing more searching. This might have been my only helpful post on this.
I remember having issues saying the words -- like my mouth was in the way. This clearly concerned me when I started taking the med at the end of June. 2011

Now, in APRIL 2012, I still have some issues.
I do not know what is left over from the stroke in 2009 and what is from the Gabapentin. There was other posts in June and July 2011 about speech. It seems that Gabapentin was effecting speech.

I sort of have a stutter every once in a while. Stuttering was not part of my speech after the stroke. It is a Gabapentin thing I believe. Maybe less than once a day (I have to pay attention and do a count) I stutter. And there is no pattern to what words give me problems. I will start making a list so I can report.

I feel like my tongue gets in the way. I wish I had documentation from a speech therapist from 2009 so I could compare before pre and post Gabapentin.

Clearly, speech got worse in a particular way in the early days of Gapapetin and some of it is still going now.

+++++++++
What a messsy post. I apologize. I do not have time to make this make more sense. I have to go --- wanted to respond.

Mari

W: :hug::hug::hug:

How much are you taking.
It's not scary --- it's the same crap as usual --- The equation of Gain vs Loss.
We take the meds for benefit and decide to keep taking them based on how much we can put up with the side effects.

My feeling is that the speech improved after a few months but I do not know. Maybe I got used to them. I am taking less than half a 300 mgs capsule.

Stay well today. Take care.

M

current user of gabapentin
 

I currently take 1200 mg of gabapentin 3 times a day. Bad news is it does not help me with any of my migraines. Gabapentin helps to calm down the nerve pain in my face and head. I also can not take any NSAIDS they cause asthma attacks. Last time I was in the ER for a migraine there cure was phengan and benadryl. My dr gives me phengan for when I get nauseous with a migraine. They are 2 cheap drugs that do help. :rolleyes:

Rae Lyn

WElcome to the room and the site.

I have phen gan and hadn't thought about it for Migraines and nauseous.

I will remember that. I could take the benedryl too. That would work with
the pressure by my nose.

Weird that those symtoms come.

Donna:grouphug::hug:

speech issues w/ Gabapentin titration - comparing notes
 

Dear Mari,

it's ok, and i really appreciate the time you already spent on this to give me some feedback. sorry i have taken so long to respond. have a bit to say is why - need brain in gear myself, lol!
This is helpful. This is also very different from my experience. My problems were more receptive than productive.

I had productive issues but they could easily have been due to the cognitive dulling and inability to focus: I had slowness in speaking and difficulty with continuity esp due to word-finding. However, I had no difficulty articulating, nor physical sensations related to articulation, such as you describe. I think if i'd been slurring mom would have told me. Now, i have slurred in the past with gabapentin but that was only when i was ramping it up on top of a high dose of Depakote: during the peak times i would become uncoordinated and the mouth was no exception, hence the slurring.

The receptive issue i had, on the other hand - unintelligible syllable salad - seems more directly related to speech (possible Wernicke's aphasia). It didn't occur to me to ask to be spoken to in English to see if that worked any better (in aphasia, one language can be messed up and another not.)
No worries, the post was just fine and I appreciated the quick response.

Thank you for investing so much time in doing the back research for me too. :hug::hug::hug: I appreciate you. :):heartthrob:

~ waves ~

gabapentin dosage, effects, titration rate
 

Dear Mari

i basically took 900 mg within the first 24 hour period.

I wanted to ramp up fast and ended up taking even more than i would have since it seemed to fix the migraine i was having right then. I took 300 + 300 starting in the afternoon Sunday - both those crashed me out (expected). Then i took an additional 300 during the night. The speech nd cognitive/focusing problems happened Monday morning.

It is scary to me. :o

It is crap yes, but in no way is it usual. i have never had this happen before with any med. :(

i have four viable languages: two i need for daily use as well as for professional purposes, the other two can also serve professional purposes and thus are definitely non-negligible. i don't have a lot of ways of earning right now besides my languages. mess with my speech centers and i get more than a little uncomfortable. :Noooo::(http://www.thesmilies.com/smilies/scared/scared0014.gif

When i took 1200mg gabapentin for a year my only side effect was increased photosensitivity - totally acceptable compared to migraines which include photosensitivity andthensome.

So far, my speech difficulties were an isolated episode. I'm going to put this to bed for now because i don't want to get freaked out about it. :o

thanks.

i have been at 750mg (300 + 150 + 300) for the past couple days. today i was supposed to increase to 900mg but i already have reason to think 750 might be enough. if this gets me through menses (which would be amazing) i'd be tempted to reduce more... see if just 600 might work on the same dosing schedule - i do take this medication rigorously at 8 hour intervals.

last time for prophylaxis, even 900 mg was not enough for migraine control - 1200 (400mg tid) worked great though. different times, different needs i suppose.

thanks again, Mari, for everything.

~ waves ~

To Rae Lyn
 

Hi Rae Lyn! :)

:welcome_sign:

Thank you for replying to me, I very much appreciate it. :)

wow, that's 3600mg total... i'd exepect if it were going to help, at that dosage, it would. that sucks since you have to take it anyway.
wow i'm sorry. i did not even know NSAIDs can cause asthma attacks. eeks. :(
Those drugs are both first generation antihistamines, they cause heavy sedation and can be used for nausea/motion sickness.

I'm familiarr with benadryl but i cannot take it - I get paradoxical agitation from it - incredible agitation. I have never used Phengan but I am not aware that it (or Benadryl) play any role in pain control??

This leaves me very much to wonder, what do the doctors in the ER give you for pain? They must give you something else... do you know?

~ waves ~

Hi, Waves, :hug: :hug: :hug:

Meds that worked a certain way in our past, work differently a few meds later. It is weird. I think you did not expect this from Gabapentin.
You are getting a good break from the headaches. That is good. :)

My thoughts are to wait before you freak out any more about the speech. It could take two weeks or more to feel less brain fog.


I forgot about the different language thing ---- prolly half remember that from a long time ago in regards to something not related to Gabapentin.

I am curious about your results in a different language.
M

Hi, Waves, :) :) :)

I wish I had been able to talk to Work Buddy about my Gabapentin side effects. Throughout summer 2011 he and I worked in my office (face to face) on a document. If I had spoken to him about my concerns then, I would have been able to get my status re words and speech.

Last summer, I remember feeling strong with very close reading even through the other issues. I have not been able to write in about 20 years --- since I started the Verapamil and Klonopin.
The receptive might have been an issue last summer. . . . but if Work Buddy noticed it he did not mention it.
It is possible that weeks and even months after being on the Gabapentin, the speech issues got better.
I feel OK now.

I really feel that you are going to be ok.
Think of the benefits.
The Gabapentin is helping. Your stomach issues are clearing up.

I hope your day is going fine.
I need to go to sleep. I have to deal with people today.

Mari

gabapentin / language / brain organization
 

right!! I absolutely did not!! :(:eek::o :hug::hug::hug:

900mg in the first 24 hours was excessive. I mean, I figured it would knock me out and make me feel drunk and unbalanced when awake, but the rest took me by surprise. I will be more cautious in future.

I'm ok now. I am sleepy during peak times but nothing caffeine can't handle for the most part. My sleeping schedule is a little crazy now too which doesn't help.

Believe me, it is SUCH a relief to wake up every morning, without a headache!!!! I still do double-takes every now and then, about the fact of not having one! :o:thud:

yes different languages use different areas of the speech center. Also, while most people have left-hemisphere dominance for language, either hemisphere may be dominant. In the case of multilinguals, left-right dominance may vary across languages.

i'm curious from an academic perspective, but not(!) curious enough to do something which will produce any degree or type of aphasia just to find out. ;):cool::Noooo: ...... However ....... if it should happen again incidentally *AND* i have the fortuitous presence of mind (HA!) to remember to switch languages - i'll let you know the outcome! :D

There is a test called a Wada test which is used before some brain surgeries (e.g. ablative surgery to correct refractory temporal lobe epilepsy) that is to affect speech areas, to test which hemisphere is dominant. For speakers of multiple languages, the Wada test must be repeated for each language.

~ waves ~

Dear Mari
 

((( Mari )))

just wanted to reply real quick to say thanks again, and wish you some good rest :Zzzz: and a good day to follow. :circlelove:

i'll reply to your other post later on... needing a break myself.

~ waves ~

I am thankful that you are getting relief from your migraines.
The support we give each other is invaluable.
((((HUGS))))
bizi

Dear Bizi
 

Thanks Bizi. It is an incredible relief. I hope it lasts. I also hope this out-of-itness lets up soon... i think i stuck my foot in it by starting too fast, but the flip side is if i hadn't, i might still be having the migraines. i dunno, but i'm just glad for now i'm not having them. (this morning i keep getting small indications of one coming... it is migraine prime time wrt my cycle, so things still look promising thus far.

Now if only Donna can get relief too.

I know what you mean about our receiprocal support.

((( :grouphug: everyone :grouphug: )))

~ waves ~

Have Neuro Appointment!!!
 

Ok.. I finally made it! The call center was finally working this morning.

I have an appointment with the neuro my pdoc knows for

June 14th - 11:00 am :)

The clinic is in the town where I used to live - 3 hours away. My pdoc also works some hours there as a state pdoc. They have another neuro also, who the clerk told me usually handles migraine cases. I was tempted to book her instead, but if I'm going to book any old headache specialist I might as well book one closer to me. The only reason I'm going there is because
-- my pdoc knows this neuro personally and recommends him as a person and physician
-- this neuro has with cross-disciplinary training in psychiatry which is handy in my case

I can always change. I will talk to my pdoc about it and see what he thinks, whether he knows or can find out anything about this other doc, since they all work at that clinic. Their migraine doc's first availability was only one week earlier anyway.

I might meanwhile shop around for a nearer headache specialist - perhaps even book just in case.

But at least, even if I do nothing more now, bottom line is:

:) I have a neuro booked! :)

~ waves ~ removing ten ton weight from mind ..... whew.

great news this morning!!!!!!
congratulations are in order.
congratulations!
6 weeks away seems like a long time to wait, but hopefully the time will pass quickly and you will be having some migraine free days with this new medication usage.
Be well.
love bizi

Hi Bizi
 

Thank you so much Bizi :):):) :hug::hug:

This is so long overdue, so... finally... :)

I haven't had a migraine since starting the gapapentin! Today I have been having twinges on alternating sides again. I should increase the afternoon dose probably but I was so sleepy this morning I stayed put today. I think I will increase it tomorrow though - that will be 300mg tid for a total of 900mg. The aim is to be totally migraine free, at the right dosage. :o

It's just as well to have the neuro some time away, because it gives me time to sort out other things, get used to the gabapentin, see to what degree the med works, make additional dose adjustments if necessary, etc.

love

~ waves ~

who prescribed the gabapentin for you?
bizi

Hey Bizi
 

originally, my first psychiatrist. here, i requested it from current pdoc as an occasional sedative. later i only accidentally found it was useful for migraines.

either pdoc or mdoc will script it for me if i ask. both know what i use it for. it has a very benign profile in terms of metabolism and interactions so they don't have a problem with it.

~ waves ~

migraine
 

famous last words. :Sigh:

got one today... mild... took extra med in the afternoon, will total 1050 mg for the day. it did help even if it took a while. i am also still phono-photosensitive. not going to stay on computer tonight. :o ((((hugs))))

Dear Waves,

'Crummy to have a migraine after thinking you have found the solution.

I hope you feel better.

M

that is a very long time to wait for an appointment.
love
bobby

Dear Waves,

This is good news. You are making progress on your list you made.

M

In my area 6 weeks in not bad for a initial visit.

Many times we have to get on a calling list to get in before
3 months. Thats how long our neuros are booked out.

So personally I think you did great.

Donna:grouphug:

Dear Mari - at 1200mg (300 qid) now, and staying there.
 

Thanks :):hug::hug: The past couple of days I've been slightly migrainey, adjusting to more med, and out of it at times due to one or the other. At more viable times I've been talking with dad about some new meds he is on, researching those, and busier with house stuff. Mom has been real tired and also has pain in her fingers, so I've been trying to help out when I can.

I really did not expect 750mg to be sufficient as a prophylactic... marveled that it had helped but Murphy's law you know, wish I'd kept my mouth shut, hehe - I am at increasing risk for migraines at the moment so, I was pretty much waiting for the other shoe to drop.

OK
- Friday 1050mg: 300 + 150 + 300 + 300.
- Saturday 1200mg: 300 x 4. (300mg q 6h)

I tolerated 1200mg well, without even excessive somnolence. It will probably take a few weeks before I can assess how truly effective it is as a prophylactic. For now, I will not increase further even for breakthrough sx.

I decided that a 750-900mg dosage was likely too low and it was more sensible to go up to 1200mg, that being the "last known good configuration" (in Windows NT crash recovery terms, lol) :p:D. I.e. It took that much last time - I know that 900mg did NOT work then.

~ waves ~

Dear Bobby
 

If it were an emergency I'd shop around. But in this case, it is just the right amount of time to settle what I need to before seeing him. I wanted my eyes adjusted to whatever new script I get. I also need to prep a readable migraine diary from my cryptic notes, and to see to what extent the gabapentin helps me, this go-around. (And the tooth thing... I will discuss that in the other thread... when I'm ready, eeks. :o )

love

~ waves ~

Dear Mari - progress/neuro
 

Yes, I finally am. :) The neuro visit is really years overdue.

I hope he can recommend a headache specialist in my area and that he might be able to counsel on risk of mania with triptans, w/ and w/o Zoloft on board. I also hope - although from what I've read there isn't much to hope for - he might know of some loophole whereby I can get gabapentin prescribed through the state (assuming, at that point, we see that the gabapentin is effective.)

it is really a big relief for me to have the appointments. I feel much less pressure. Making appointments is harder for me than going to them... until maybe a couple days before when I might get anxious over travel, meeting someone new etc. In this case I had to verify that there were routes to get me up there easily enough... I verified the route down to the stop where I need to get off. LOL! I know the area so that part won't be difficult. I only have the timing to plan now. Having done so much of the necessary prep work for this also reduces anxiety. I might go ahead and plan the timing too. Then I will really feel "all set." :)

~ waves ~

Dear Donna
 

Thanks Donna. :):hug::hug::hug:

Yes, I know what you mean! It is the same here, except they don't have waiting lists. In general, it is hard to get in to get an appointment with any specialist sooner than 2-6 months from when you call, unless there happened to be a cancellation.

When I went to the "supposedly" best headache center in the city (only to be treated like dirt and not even given formal diagnostic paperwork grrrr) ... i had to wait ONE YEAR for my first appointment. And then 7 months for the followup because they wanted an MRI. I think if my mdoc had been more on the ball, he could have ordered the MRI himself so I would have had it for the first appointment, but often that is how they play the game here - send you to the specialist for whom you must wait, the specialists orders tests - sometimes basic ones the doc could very well have ordered - then another long wait.
Not much we can do about it. :Sigh: Just sucks. :o

:hug::hug:

~ waves ~