17 replies to this topic

[james-lee]

My neurologist tells me today that she has exhausted all medications she knows of for migraines. She's sending me to see experts at a university. I can't get in there until September...in the mean time she says if I have a migraine to put lidocaine in my nose, and if that doesn't help to "go lay down." Meanwhile, I take tramadol for my chronic daily headaches, which she thinks can cause rebound headaches, and she tells me to only take it when I really need it. I think this woman is kind of downplaying the sort of pain I am in, and I don't think she has exhausted all possiblities, like she says. I know she is frustrated because I can't take certain meds, like anti-depressants or anti-psychotics...both cause a feeling of impending doom and inner turmoil that makes me a suicide risk. So, here I am stuck, in pain. I don't know what else to do. I've tried all kinds of anti-convulsants, and either they did not work or the side effects were bad. My blood pressure doesn't support beta blockers or calcium channel blockers. Nsaids mess up my stomach, especially being on iron for anemia. I just can't believe she up and abandoned me this way.
So, anyway, what has helped your migraines?

[creepy]

I havent found anything for migraines but then again I get them so infrequently that its nowhere near as much of an issue.
I can easily get a migraine if I sleep too late. No idea why. Then im pukey and in agony the rest of the day.
As far as I understand migraine is usually caused by changes in blood pressure or pressure on the brain from fluid, etc.
Im assuming youve had CT scans and tests done? Tried meds like neurontin and cymbalta?
Might be worthwhile to see a neurologist. Or a new one if you already have.

[james-lee]

My neurologist seems to be giving up on me. I can't take nsaids because of stomach issues and I am on iron for anemia. Neurontin didn't help. I've been on all kinds of anticonvulsants, even lamictal. I'm going to a headache clinic but I can't get in for five months, so between now and then I am stuck with incredible pain. My migraines worsen with bad weather. Sometimes I will go a week without one, other times I will have them every day, one after another.

[mickmax]

Accupressure, massage.

[elocinintherain]

What have you tried for your migraines? Have you tried Topamax, Neurontin, beta blockers, or anything like that?
Edit: sorry, re-read post. If I were you, I'd see the expert, make sure there's nothing physical causing them. If at all possible, don't take anything for them for awhile, to kill off the rebound headaches. Then, try an elimination diet with some supplements. Can you find a homeopathic doctor? Massage, Acupuncture, etc are also good alternatives.

Good Info:
http://www.mayoclini...dsection=causes

Migraine triggers
Whatever the exact mechanism of headaches, a number of things may trigger them. Common migraine triggers include:

* Hormonal changes. Although the exact relationship between hormones and headaches isn't clear, fluctuations in estrogen seem to trigger headaches in many women with known migraines. Women with a history of migraines often report headaches immediately before or during their periods, and this corresponds to a major drop in estrogen. Others have an increased tendency to develop migraines during pregnancy or menopause. Hormonal medications, such as contraceptives and hormone replacement therapy, also may worsen migraines.
* Foods. Certain foods appear to trigger headaches in some people. Common offenders include alcohol, especially beer and red wine; aged cheeses; chocolate; fermented, pickled or marinated foods; aspartame; overuse of caffeine; monosodium glutamate — a key ingredient in some Asian foods; certain seasonings; and many canned and processed foods. Skipping meals or fasting also can trigger migraines.
* Stress. A hard week at work followed by relaxation may lead to a weekend migraine. Stress at work or home also can instigate migraines.
* Sensory stimuli. Bright lights and sun glare can produce head pain. So can unusual smells — including pleasant scents, such as perfume and flowers, and unpleasant odors, such as paint thinner and secondhand smoke.
* Changes in wake-sleep pattern. Either missing sleep or getting too much sleep may serve as a trigger for migraine attacks in some individuals.
* Physical factors. Intense physical exertion, including sexual activity, may provoke migraines.
* Changes in the environment. A change of weather, season, altitude level, barometric pressure or time zone can prompt a migraine.
* Medications. Certain medications can aggravate migraines.

and this too:

Alternative medicine
By Mayo Clinic staff

Nontraditional therapies may be helpful if you have chronic headache pain:

* Acupuncture. In this treatment, a practitioner inserts many thin, disposable needles into several areas of your skin. The penetration is so shallow and the needles are so thin that acupuncture generally causes little or no pain or discomfort. A number of clinical trials have found acupuncture may be helpful for headache pain, but evidence from these trials isn't strong enough for experts to routinely recommend this treatment.
* Biofeedback. Biofeedback appears to be especially effective in relieving migraine pain. This relaxation technique uses special equipment to teach you how to monitor and control certain physical responses, such as muscle tension. This technique can be combined with preventive medications.
* Massage. Although massage is a wonderful way to reduce stress and relieve tension, its value in treating headaches hasn't been fully determined. For people who have tight, tender muscles in the back of the head, neck and shoulders, massage may help relieve headache pain.
* Herbs, vitamins and minerals. There is some evidence that the herbs feverfew and butterbur may prevent migraines or reduce their severity. A high dose of riboflavin (vitamin B-2) also may prevent migraines by correcting tiny deficiencies in the brain cells. There is also some evidence that coenzyme Q10 supplements may be helpful in some individuals. Oral magnesium sulfate supplements may reduce the frequency of headaches in some people, although studies don't all agree on this issue. In addition, infusions of magnesium sulfate seem to help some people during an acute headache, and they seem to relieve migraine pain in people with magnesium deficiencies. Ask your doctor if these treatments are right for you. Don't use feverfew or butterbur if you're pregnant.
* Cervical manipulation. There are no scientifically valid studies that prove that chiropractic or other spine-manipulation treatments are effective in the treatment of migraine.

Edited by elocinintherain, 28 April 2009 - 03:16 PM.

[james-lee]

What have you tried for your migraines? Have you tried Topamax, Neurontin, beta blockers, or anything like that?
Edit: sorry, re-read post. If I were you, I'd see the expert, make sure there's nothing physical causing them. If at all possible, don't take anything for them for awhile, to kill off the rebound headaches. Then, try an elimination diet with some supplements. Can you find a homeopathic doctor? Massage, Acupuncture, etc are also good alternatives.

Thanks for the info. I've had mri's and stuff, but nothing showed up. I can't not take pain medicine because I also have very painful arthritis in my hands and feet and carpal tunnel syndrome (that I am going to physical therapy for now). I would love to not have to take stuff.

[rkontos]

My neurologist seems to be giving up on me. I can't take nsaids because of stomach issues and I am on iron for anemia. Neurontin didn't help. I've been on all kinds of anticonvulsants, even lamictal. I'm going to a headache clinic but I can't get in for five months, so between now and then I am stuck with incredible pain. My migraines worsen with bad weather. Sometimes I will go a week without one, other times I will have them every day, one after another.

One I tried I might mention because I had tried alot of different meds and the Headache specialist I saw thought I was caught up in a rebound cycle, migraine then rebound headache and so on and on. It was D.H.E. It is delivered in shot form that you must drawn up at the time of injection not prior. It hurts going in but if you ice the spot prior it will lessen the pain. This DHE stopped the cycle and helped. It is not necessarily a long term med just one to stop the cycle so the preventive meds can work.

Good luck I know it is hard. One other thing I heard about was magnesium oil you rub it on your feet or soak your feet in it and it will help. This I got from an ICU nurse.

It is good for a lot of things and migraine is one of them. Helps gets your magnesium levels up without having to go through the digestive system.

rsk

ps. chiropractor helped too.

Edited by rkontos, 29 April 2009 - 07:44 PM.

[james-lee]

Oh yeah, I see a chiropractor and that has helped. It's helped my carpal tunnel out too. I've never heard of DHE.
I'm not sure if my chronic daily headaches are rebound because I had them before I started taking pain meds. The doctor thinks I have hemicrania continua. Usually indocin is prescribed for that, but my stomach couldn't handle it.
Can rebound pain happen in other parts of your body?

[elocinintherain]

Oh yeah, I see a chiropractor and that has helped. It's helped my carpal tunnel out too. I've never heard of DHE.
I'm not sure if my chronic daily headaches are rebound because I had them before I started taking pain meds. The doctor thinks I have hemicrania continua. Usually indocin is prescribed for that, but my stomach couldn't handle it.
Can rebound pain happen in other parts of your body?

I am not sure if rebound pain is possible in other parts of your body.
However, there are some meds for migraines that you take in a nonpill form.
Have you tried different triptans in spray form for migraines?
Migranal, Imitrex, and a few others come in spray form, so they would be more gentle on your stomach.
I know you have said that most anti-depressants and beta blockers won't work for you, but have you tried small doses of topamax, neurontin, or depakote? Some of these drugs come in alternative forms.
Oh, I almost forgot... Imitrex is being tested in patch form. That might be an option for you when it comes out:
http://www.medicalne...cles/113816.php

[dymphna]

Exactly WHICH have you tried, and for how long:

Topamax
Neurontin
Lamictal
Depakote
Trileptal
Tegretol

Beta Blockers

NSAIDS:

Celecoxib (Celebrex) Diclofenac (Flector, Cataflam, Voltaren, Arthrotec (combined with misoprostol)) Diflunisal (Dolobid) Etodolac (Lodine, Lodine XL) Fenoprofen (Nalfon, Nalfon 200) Flurbirofen (Ansaid) Ibuprofen (Motrin, Tab-Profen, Vicoprofen (combined with hydrocodone), Combunox (combined with oxycodone)) Indomethacin (Indocin, Indocin SR, Indo-Lemmon, Indomethagan) Ketoprofen (Oruvail) Ketorolac (Toradol) Mefenamic Acid (Ponstel) Meloxicam (Mobic) Nabumetone (Relafen) Naproxen (Naprosyn, Anaprox, Anaprox DS, EC-Naproxyn, Naprelan, Naprapac (copackaged with lansoprazole)) Oxaprozin (Daypro) Piroxicam (Feldene) Sulindac (Clinoril) Tolmetin (Tolectin, Tolectin DS, Tolectin 600)

Triptans:

sumatriptan (Imitrex®, Imigran®) injections
sumatriptan (Imitrex®, Imigran®) tablets
sumatriptan (Imitrex®, Imigran®) nasal spray
zolmitriptan (Zomig®) tablets
naratriptan (Amerge®, Naramig®) tablets
rizatriptan (Maxalt®) tablets and rizatriptan orally dissolvable (Maxalt-MLT®) tablets
zolmitriptan orally dissolvable (Zomig-ZMT®) tablets
almotriptan (Axert®) tablets
frovatriptan (Frova®) tablets
eletriptan (Relpax®) tablets
zolmitriptan (Zomig®) nasal spray

I ask because each drug works differently, and some may even exacerbate an issue. Even drug type will effect how it works for a particular person - I had zero result from oral Imitrex, but could take the injection. Also, some meds will give you a horrible side effect when used in combination w/ other things, but not on their own (eg: I had a GI bleed out on Naproxen, but I was also on 3 other meds. I can now take it w/o issue).

Sometimes a neuro will not Rx a particular NSAID if the patient has failed one in the same "class" (all NSAIDs are broken into classes). Other docs won't do this, on the presumption that a similar base med, in a different formulation, may be just right.

Finally, there is the option of Botox injections. But good luck finding anyone qualified to do that.

And the doc is right about the Tramadol re-bound. You may have to gut through the withdrawl of it before you find anything that works.


Dymphna

[james-lee]

Exactly WHICH have you tried, and for how long:

Topamax
Neurontin
Lamictal
Depakote
Trileptal
Tegretol

Beta Blockers

NSAIDS:

Celecoxib (Celebrex) Diclofenac (Flector, Cataflam, Voltaren, Arthrotec (combined with misoprostol)) Diflunisal (Dolobid) Etodolac (Lodine, Lodine XL) Fenoprofen (Nalfon, Nalfon 200) Flurbirofen (Ansaid) Ibuprofen (Motrin, Tab-Profen, Vicoprofen (combined with hydrocodone), Combunox (combined with oxycodone)) Indomethacin (Indocin, Indocin SR, Indo-Lemmon, Indomethagan) Ketoprofen (Oruvail) Ketorolac (Toradol) Mefenamic Acid (Ponstel) Meloxicam (Mobic) Nabumetone (Relafen) Naproxen (Naprosyn, Anaprox, Anaprox DS, EC-Naproxyn, Naprelan, Naprapac (copackaged with lansoprazole)) Oxaprozin (Daypro) Piroxicam (Feldene) Sulindac (Clinoril) Tolmetin (Tolectin, Tolectin DS, Tolectin 600)

Triptans:

sumatriptan (Imitrex®, Imigran®) injections
sumatriptan (Imitrex®, Imigran®) tablets
sumatriptan (Imitrex®, Imigran®) nasal spray
zolmitriptan (Zomig®) tablets
naratriptan (Amerge®, Naramig®) tablets
rizatriptan (Maxalt®) tablets and rizatriptan orally dissolvable (Maxalt-MLT®) tablets
zolmitriptan orally dissolvable (Zomig-ZMT®) tablets
almotriptan (Axert®) tablets
frovatriptan (Frova®) tablets
eletriptan (Relpax®) tablets
zolmitriptan (Zomig®) nasal spray

I ask because each drug works differently, and some may even exacerbate an issue. Even drug type will effect how it works for a particular person - I had zero result from oral Imitrex, but could take the injection. Also, some meds will give you a horrible side effect when used in combination w/ other things, but not on their own (eg: I had a GI bleed out on Naproxen, but I was also on 3 other meds. I can now take it w/o issue).

Sometimes a neuro will not Rx a particular NSAID if the patient has failed one in the same "class" (all NSAIDs are broken into classes). Other docs won't do this, on the presumption that a similar base med, in a different formulation, may be just right.

Finally, there is the option of Botox injections. But good luck finding anyone qualified to do that.

And the doc is right about the Tramadol re-bound. You may have to gut through the withdrawl of it before you find anything that works.


Dymphna

But rebound can happen from any pain medicine, even tylenol. I have arthritis in my feet, and a painful bone spur. I can barely walk without taking something. I can't take nsaids right now because I have to take iron. I can't take beta blockers because my bloob pressure is too low. Triptans make my heart pound very hard and the doctor won't give them to me anymore. Can't take antidepressants or antipsychotics because of the adverse psychological effects.
These are the anticonvulsants I've tried:
topomax--on it for 6 months, gained 30 pounds and it stopped helping the headaches even at higher doses. Did help at first.
depakote--only on it a month, did nothing but make me sleepy and sick to my stomach
neurontin--on it for 6 months, stopped working even at higher doses
lamictal---gave me a rash in the first few days...didn't work anyway

I'm going to give the lidocaine a try. Hopefully it will at least work for the migraines. I don't have rebound headaches yet, because I haven't been taking tramadol for that long on a daily basis. I've had chronic daily headaches for some time now, before every taking any pain meds. I am worried about getting them, so I am only taking the tramadol when I really really need it.

[mickmax]

Seriously, book a massage. You wouldn't believe how much it helps.

[Nutter 6]

Botox sounds worth a try. If you need help finding someone who can do it for you, I have a friend who works at Mayo Clinic, is also a migraine sufferer who uses botox, and also is an advocate with insurance companies for people who have tried everything else and need to be approved for Botox--she gets them to pay for Mayo doing the treatments.

According to her, it won't stop the migraines, but it keeps them from progressing. Instead of becoming an 8 or 10 on the pain scale, they stop around a 4 or 6, and other meds can then do some good.

I'll bet Mayo knows of doctors at other places who do it, and has language for letters to insurance companies. PM me if you want to follow up--there's no reason she'd have to know your name, just roughly where you live, to give you some ideas.

[mj1127]

How high in dosage did you go with the Depakote? I found it didn't help my migraines until I reached 1000mg, and then it was breathtakingly effective. No migraines at all for months. As far as stomach upset goes, did you take it with food? Before bed? These are two things that help some people. I never had a problem with that, but I also take Nexium, and I wonder whether that was the reason. Anyway, if you didn't get up high enough, it might not have worked. I found the sleepiness did wear off some.

[Sduibek]

http://www.crazymeds...amp;#entry49977

[bluedog]

I'd like to hear how it went at the headache clinic? Or if anyone can post input about headache clinics / Mayo clinics for migraines.

[Tricia]

My doc gave me Midrin for my migraines. It's old school and was replaced by the newer tryptan-types because they work a little better. I haven't had a really bad migraine to test out, but it's helped with the weekly headaches I get. She probably never gave it to you since you've been on the newer stuff, but maybe it will help.

Edit: Oh damn, I just noticed that this was originally like a year ago.

Edited by Tricia, 13 July 2010 - 11:59 AM.

[kennedyhancock]

I found that Fiorinal aka aspirin, butalbital, and caffeine works well for me. I generally have an aura before they start, take a tab and retreat to a cool dark area where I can lie down for 1\2 hour or so. i will also slather on some Ben Gay mentholated with asprin cream on my forehead and the side of my temple most affected. It turns my eyes red and stings but it seems to help until the Fiorinal kicks in. Then I take one or two tablets every four hours to keep it at bay.