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Neurology (Expert Forum)
DAILY HEADACHES/MIGRAINES
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
DAILY HEADACHES/MIGRAINES
by BAILEYHY, May 27, 2002 12:00AM
I am a 37 y/o female. I was diagnosed with migraine headaches about 17 years ago. At the time my PCP rx'd Fioricet which helped. They steadily became worse and over the past two years I have seen my neurologist and had several cat scans, MRI's and most recently an MRI with angiography. The only thing that was ever noted was a tiny constriction of a vessle in my right temple, "of no significance."
We (PCP and the GYN I work for) thought for a long time the headaches were hormonal. I have done numerous diaries to rule out foods, triggers, etc, my headaches have NO pattern except that they are worse when there is a low pressure system here. I have sinus issues also, which are easily controlled on their own and take Claritin daily. I tried Depakote which worked for 18 months or so, then was put on Topamax, now taking 100mg-I'm not impressed.
In March I had a bilateral salpingo-oophrectomy and hoped the headaches would improve with HRT, but they are worse. I have had daily migraines, usually waking with one, but again not a real pattern, they can occur any time. I do have complete relief with Amerge or Maxalt but having to take 2 tabs and insurance allowing 9 per month, it gets tricky. I know my system has to regulate hormone wise, but I'm becoming more frusterated. I have a concern about taking medication regularly, which my PCP states is not an issue. ANY input or thoughts you might have would be greatly appreciated. Thanks!
I apologize for this not being more organized, I really didn't expect to be able to post today, I've been attempting for so long.
We (PCP and the GYN I work for) thought for a long time the headaches were hormonal. I have done numerous diaries to rule out foods, triggers, etc, my headaches have NO pattern except that they are worse when there is a low pressure system here. I have sinus issues also, which are easily controlled on their own and take Claritin daily. I tried Depakote which worked for 18 months or so, then was put on Topamax, now taking 100mg-I'm not impressed.
In March I had a bilateral salpingo-oophrectomy and hoped the headaches would improve with HRT, but they are worse. I have had daily migraines, usually waking with one, but again not a real pattern, they can occur any time. I do have complete relief with Amerge or Maxalt but having to take 2 tabs and insurance allowing 9 per month, it gets tricky. I know my system has to regulate hormone wise, but I'm becoming more frusterated. I have a concern about taking medication regularly, which my PCP states is not an issue. ANY input or thoughts you might have would be greatly appreciated. Thanks!
I apologize for this not being more organized, I really didn't expect to be able to post today, I've been attempting for so long.
Doctor's Answer
by CCF-Neuro-M.D.-JT, May 28, 2002 12:00AM
If you're having nearly daily headaches, you may need to consider taking a preventive med regularly. It's understandable that you are concerned about side effects, but it may be the most effective way to cut down on the amount of expensive meds like Amerge and Maxalt. Inderal, doxepin, or verapamil as well as elavil have been helpful for many patients and they are relatively safe with less side effects than depakote. As for abortive therapy, if you run out of the Maxalt and Amerge (glad they work for you), for migraines try a combination of motrin 500mg with benadryl 25mg. You should be able to sleep it off, but If no improvement is seen, repeat the benadryl and try tylenol XS 500mg. We do this with kids also (at lower doses) as it has a safe side effect profile. HRT is well known to cause headaches so you'll have to work closely with your GYN to find the optimum dose regimen for you. Finally, consider seeing a neurologist who specializes in headaches or a chronic pain clinic for closer evaluation. GOod luck.
Has anyone, family doc;neurologist etc. ever suggested that this is chronic cluster headache syndrome?
www.clusterheadaches.com
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