OT: Drugs for Migraines

[The Choker]

My wife has migraines several times per year and only treats them with acetaminophen and rest. This one has lasted three days and was triggered by being stressed over severely declining health of her mother.

My wife is a beautiful woman, otherwise healthy and has a youthful attractive figure. It hurts me to see her in such pain and there is nothing I can do.

I believe there are some new drugs in the last ten years for treating migraines. Have any of you had success with these?

[robysue]

My heart goes out to your wife.

For many years I "ignored" my migraines. I'd treat them with ibuprophen when they got bad enough and simply go to bed and try to sleep them off in my pre-CPAP days.

When the migraines morphed into vertigo and (unknown to me) were also adding to my misery of adjusting to CPAP, I finally wound up being referred to a neurologist by way of an ENT who could find nothing wrong in my inner ear to account for the vertigo.

Thus began my long (and not very successful) trial of three different migraine prophylactic drugs. Drugs used to prophylactically treat migraines come from a wide range of drugs developed for other conditions. The three that I tried were all anti-seizure meds. They all prevented the headaches wonderfully, but I simply could not tolerate the side effects.

Eventually I was put on a vitamin regime to control/prevent my chronic migraines. I now take 200 mg of Vitamin B2 (Riboflavin) and 200 mg of Magnesium twice a day for a daily does of 400 mg of Vitamin B2 and 400 mg of Magnesium. I'm also taking a prescription form of folate called Deplin because I've got a gene mutation that causes my body to not metabolize folic acid and folate very well. This seems to be controlling my chronic migraine pretty well---based on my headache logs and my own daily sense of "wow, no headache today" much of the time.

For acute migraines, I now have a prescription for Maxalt. For me, the Maxalt is highly effective---if I take it as soon as the pain starts. The down side of Maxalt is that you can't repeat the dose in a hour or so if there's been no reduction in pain. I'm also on the name brand ($$) because my neurologist wants me to be able to take it without water if need be. (The name brand has a version that dissolves on your tongue almost instantly; the generic only has ordinary tabs available, and the ordinary tabs require water.)

I would strongly encourage your wife to ask for a referral to a neurologist who has some expertise in treating headache pain for proper evaluation of her migraines. If they occur infrequently, but are very painful, the neuro will most likely prescribe something similar to Maxalt that is to be taken as soon as she knows a migraine is starting. If she's getting 10 or more migraines each month, the doc may want her to try prophylactically treating them.

[The Choker]

Thanks.

[nanwilson]

My granddaughter takes Excedrin-migraine...works for her. When I had them years ago, I started taking Vitamin B - complex (every day) worked for me. I guess I was low on vitamin B.
Good luck.

[Kaylis too]

I'm going to try the vitamin combo to see if it helps my migraines. I also get them from bright sunlight so I usually wear dark amber wrap around sunglassses. It seems to be the contrast from a darker area to the brightness that is the most consistent trigger for those so I also try to stop part way when possible to let my eyes and head adjust.

As for meds, I've never been on preventatives, though I probably should be since they occur anywhere from two a month to several in a week and sometimes last for days. A couple of times I've been told I am having cluster headaches too. These seem to be a specialized migraine that keeps reoccurring -- the worst for over a month period almost daily. Maxalt helped me too, as does the Imitrex vaccination at the doctors. This, in fact, is the only thing to kick those cluster headaches in the butt! I'm now on tablet Imitrex, and this has been doing a good job.

I hope your wife finds some help, and I do suggest a lightweight, breathable hat and dark, wrap around sunglasses. They can't hurt and could help quite a bit.

[Julie]

What about prescription meds like Imitrex that came out years ago specifically for migraines - do they not work, or do they have side effects?

[Slartybartfast]

Migraines are awful. Mine started when I was 13 got worse in college and post grad studies, then moderated when I started working, and now are only a 4-5 time a year 30 minute forced time-out while I wait for my vision to return. I had to quit college twice because of them. Now, Tylenol Migraine handles the residual pain after the light show and holes in my vision moderate.

Recently, BOTOX has been approved for prophylactic treatment of chronic migraine. http://www.webmd.com/migraines-headache ... -migraines Your wife might be a candidate for its use. A neurologist, preferably a headache specialist, would be the best specialist to see. The key to its effectiveness is in the proper injection technique. Only a specialist who has received the proper training can put the drug where it needs to go. Same for the cosmetic product, BTW.

[MaxDarkside]

Migraines I think have many causes and are of various forms. My wife takes:

Relpax

VERY effective for her. Feels one coming on, pops a Relpax... tick tock.. GONE. Hers may be of a particular form that Relpax helps. The other migraine drugs do not help or have side effects that affect her. Prescription only, and you can only take a few per week.

[chunkyfrog]

Some people self-medicate with caffeine (strong coffee)
This no doubt counts as folk medicine.
Drug companies probably don't approve, though.
Not sure of the effect on a real migraine--as many of these folks may not have a real diagnosis.

[Slartybartfast]

Caffeine is contianed in Tylenol Migraine. And for years doctors have told me to drink a cup of strong coffee to see if that would help. So it's not just folk medicine. However, neither does it work for everybody. I think as Max said, there are many causes, and not everybody responds the same way. Mine used to be triggered by eating garlic or onions. That's gone now, for some odd reason.

[robysue]

Re caffeine for migraines.

It can be a big help to many migraineurs. And it can also make ibuprophen, aspirin, and acetemenophen all more effective against headache pain in general and migraine pain in particular. So it's often added to OTC pain meds with a "for Migraines" added to the label.

And then add in the fact that caffeine withdrawal headaches can hurt in a way similar to migraine headaches. And of course the standard cure for a caffeine withdrawal headache is a shot of your favorite caffeine-laden beverage ...

So it's no wonder that caffeine is a standard folk remedy for headaches: It works for many people and it doesn't make things any worse for most people.

But for some migraineurs, caffeine is a double-edged sword: Caffeine can trigger migraines in some folks. Or make an existing one worse. It took me a very, very long time to realize that my morning cup of coffee was in fact triggering headaches. Still miss my morning caffeinated coffee (decaf just doesn't taste the same) and I genuinely morn the loss of unsweetened ice tea when I'm eating out. (Brewed decaf tea makes a decent iced tea; but it's all but impossible to find a restaurant that has unsweetened, decaffeinated iced tea available.)

And the not-so-funny thing about the prescription stuff for migraines is this: No medicine seems to be effective for the vast majority of migraineurs, but lots of medicines are partially effective to very effective for many migraineurs. And so the typical way of treating migraines with prescription meds involves some trial and error. But there are a lot of things out there on the market now that a neuro can prescribe for migraine pain. And if one doesn't work, there are typically many other choices to try.

If she's getting 10 or more migraines each month, the doc may want her to try prophylactically treating them.

It's more like six per year.

In addition to stress, exposure to bright sun seems to trigger them. She no longer goes boating with me unless it is a completely overcast day.

Six headaches per year or so that are real whopping bad ones? Chances are if she asks a doctor for a prescription for dealing with the migraines, she'll be given something to take "as soon as the pain starts". Maxalt, Immitrex, Relpax, Zomig, Amerge, and Axert are all triptans that work well in some folks. Ergotamine and caffeine combos are another set of prescription migraine meds. They have an overall reputation of not being as effective as the triptans, but for some folks they are more effective.

[cowlypso]

I would definitely encourage her to see her doctor and get a prescription for a migraine med. If she's never seen a doctor for migraines before, they will probably want to do a CT scan of her head just to make sure there's no underlying cause. They might also refer to a neurologist. But the triptan drugs are SO much better than over-the-counter stuff.

[hobbs]

Another vote for Maxalt. My wife has had severe migraines for 40+ years and this is the only thing, besides being put out cold, that has helped.

[BlackSpinner]

Most of my migraines were cured by a complete hysterectomy.

As long as I stay away from cleaning chemicals and industrial glues and crap like that I am down to simple ocular migraines.

[SleepyToo2]

To the poster who asked if the newer drugs have side effects: of course they do - all drugs do. In my case, with Zomig I was getting hypersensitive skin (think a burning feeling in a cool shower - couldn't tolerate the hot shower!). However, the cure was definitely better than the migraine. Then I went on the vitamin B and magnesium supplement program described above, changed my job, and started on CPAP. Just which of these was responsible for migraines not coming to visit me very often I have no idea. However, whether it was one, an other, or all of the above, I don't really care. I just enjoy the waking up without a migraine!