Amitriptyline
 

Hello All,

This is my first post; however, I have been visiting this site for quite some time looking for information on migraines.

My teenage son has been diagnosed with a transformed migraine and was prescribed amitriptyline. We've been told it takes 4-6 weeks for this medication to begin helping.

Unfortunately, it's been four weeks and he has not had any relief whatsoever. We were hoping there would be some gradual improvement as the four week marked approached.

I'm wondering if we're being too impatient and need to keep hanging in there, or if we should be noticing some effect (even a little) by now?

Thanks for any suggestions.

I haven't heard of the use of this medication for treating migraines. However, I do know that Topamax is widely used with much success. Perhaps your doctor would let you have your son go on this and see if he gets relief.

Good luck and let us know how you are doing.

Thanks Fig4. We already gave Topamax a try, but he had so many side effects from it, they switched him to Elavil. I believe its an older medication that can be very helpful for migraine. I'm just concerned about how much more time we should invest in it, if it's not going to work for him.

Ellavil is an oldie but goodie in a lot of chronic pain situations. From back pain to migraines, many MDs are now starting to reach for the tried and true stuff of yesterday instead of the new fangled stuff.

It did not work for me, but nether did topamax and some other stuff. It did however work for my niece and she found great relief.

It can make you pretty sleepy to start with so maybe a bed time dose is best till you get used to it. I felt hungover for a week and then I started to get used to it. once I got adjusted it was fine.

Best of luck! :hug:

Hi sylviegirl, Welcome to NT.

Meds work differently on everyone. The time ranges they give are averages; there will always be a number of people for whom a med works faster or slower, and to different degrees. It's also impossible to tell if the effect will be gradual or sudden/dramatic.

As long as your son isn't experiencing any intolerable side effects, I'd hang in there - maybe even a couple extra weeks (to 2 months) before hanging it up, but that's up to you. Likewise, any med that does cause intolerable side effects should be reported immediately, and discuss a change.

You can always call your doctor and ask the question.

Doc

Thanks Doc! That's exactly the kind of information I was looking for. After four weeks in, we really hesitate to switch meds now. Based on your response, it sounds like there's still a possibility it will be helpful. I appreciate your help.

Thanks Dejibo. Topamax did nothing for us either... I've heard good results with the Elavil and am hopeful it may still do the trick. I appreciate your help!

In the meantime... there are some things you & son can do to help his doctors help him. If you haven't already...

Keep a headache log. For examples/samples, Google: headache log
and use one of those, or tailor your own. If your son is into it, he may even enjoy making up his own on Excel, Visio, etc. and tweaking it to his own needs/situation.

Learn all you can about headaches & migraines to help figure this puzzle out.
Google: migraine types
Google: migraine diagnosis
Google: migraine treatment
Google: migraine prophylaxis
and anything else you can think of. The more you learn/know about these cussed things, the better you can help...

Is his doctor a migraine specialist (not just a neurologist who says he knows/treats headaches/migraine) - one whose practice is limited to just migraines? This can make all the difference, if you can find one.

Doc

elavil is ameritriptyline.... have you been checked for Chiari malformation

Amitriptyline
 

Razzle - maybe. I'm not sure, although a lumbar puncture was done, nothing was ever said about Chiari.

We've had some success with the amitriptyline and cyproheptadine combinination. In fact, there was so much success, we were instructed to wean from cyproheptadine. Everything was great...off the med for about three weeks and the headache returned with a vengeance.

I'm inclined to think the amitriptyline hasn't done anything and it was all the cypro. It's been suggested to up the amitriptyline instead of re-adding the cypro.

Is it common to keep increasing the amitriptyline dose over time?

I've heard of it being increased to find the right therapeutic dosage (called titrating) but over time can indicate a development of tolerance. How much was he originally prescribed, and how much are they increasing it to? (I've heard of 10, 20 & 30 mg for migraine).

There may be more info available by googling: amitriptyline for migraine

If you're looking for alternatives to discuss with his doctor, try the searches I mentioned previously.

Doc

Thanks Doc. Yes, I googled some of your earlier searches and found them helpful. Sorry, I had thought I responded to that post, but see I did not. We are going to a headache specialist next month. The current neurologist doesn't seem to think outside the box. We are not experiencing cookie cutter symptoms here and we are becoming frustrated.

My gut is telling me the amitriptyline is not giving him relief and not knowing if the amitriptyline is actually helping, or not, we are struggling with upping the dose, or weaning. We started with 10 mg and increased by that amount until we reached at 50 mg. He never actually had relief until the cyproheptadine was added, but then it was stopped fairly soon and the headaches returned. They now want to increase the amitriptyline to 75 mg.

The side effects from the amitriptyline are starting to wear on him and we do not want to increase this med...especially not knowing if it's actually helping or not. Thanks for your help. I'm just looking for some answers and/or possibilities to take to the headache doc.

that cypro is a antihistamine for allergys ... how does that headaches ??

here are the symptoms of Chiari malformation and the only way to find out is by Cervical MRI . have just your family dr order one . and then you will know

http://chiaricare.com/Chiari-1-Malfo.../Symptoms.aspx

I will definitely check out the link and add this to my list of items to ask about. Thank you. Can you have Chiari with a normal lumbar puncture pressure?

As far as the cypro, its used for migraine in pediatrics. I thought the same thing but it worked great. The only problem for him is drowsiness. It also increases appetite, but he needed to gain a little, so that wasn't an issue.

I can relate to that. Early on in my migraine journey, my PCP had to enter something in his computer as to the type of migraines I had. He apologized for being slow about it (not that I even noticed), remarking, "They have 22 different classifications of migraine in here, and none for 'other' and that's what you have. ...Oh, there it is."

Googling: amitriptyline migraine dosage I found:
and a study indicating increasing dosages may not be more effective, and more. I did not spend a lot of time perusing but it appears there are some worthwhile articles in that search.

The high doses of amitriptyline surprised me. In my own experiences with it, 10 mg is enough to lay me out for a day and a half. I may have an unusual sensitivity to this medication.

Personally, I'm not keen on using it for an adolescent for any reason because of the black box warning and associated side effects. OTOH, no parent wants to see their offspring suffer these blasted things.

I hope you have better success with the headache specialist.

Not for nothing, but how is your son's posture? Does he spend a lot of time at a computer?

Doc

Thanks Doc. Those were wonderful links and I spent a great deal of time reading through them today. If anything I think they may have convinced me he needs to come off of it and we need to try something else. If it was working great, it would be an easier decision. However, it's not working well at all and I'm not so sure it's worth the risk to keep upping the dose and then have to worry about getting him off it at a later time. The withdrawals from this sound difficult. Granted, there's not too many good news stories on the internet and difficulties run rampant, but he's so young...I'm more petrified to keep him on it in light of how he's feeling.

BTW, he's not a big computer buff, but I understand your concern. He has spent all summer at PT and, believe me, he pays attention to his posture more than any kid I know! :)

Thanks a ton for your well wishes, suggestions and links. It's greatly appreciated.