Medication Questions?

[nrse1231]

Hello,
I am a 39 year old female that has been having migrains since 2000. I am currently taking 800mgs of neurontin 4 times a day, 0.5 mgs of ativan twice daily, 20mgs of baclofen twice daily, and now my neuro has just added 250 mgs of depokote twice daily to the mix.  I take Midrin as needed as well as darvocet as needed for the migraines and when that doesn't work, it's a trip to the ER for a treatment of a Demerol Shot and a Phenegran shot.

I am so sick of dealing with these migraines.  Will the latest addition of depokote to the mix maybe help?
Thanks

[LifesAHeadache]

For your level of Migraine pain, this is not that many meds.  I see a clear preventative regimen, clear rescue meds, and ER Acute management that you don't get all that often.  An now Ativan gives "rebound headaches".  Don't ever stop a med without express permission from your doctor.  And frankly, Midrin and Darvocet are pretty low on the pain management scale so I would not deny yourself pain relief until you find a preventative that works.  And rebound headache does not stop a preventative from kicking in, if you even have rebound.  Are you taking Ativan for stress or to sleep in an effort to increase deeper stages of sleep?  If it is for stress than I would ask neuro if maybe anti-depressant line may be a choice.  Many people with psych symptoms kill two birds with one stone by using anti-depressant therapy for psych and pain approach.  Remember you can only make one change at a time to your preventative regimen in order to find which medicine is helping.  If you want to go without pain meds that is fine but don't deny yourself pain relief when you don't have to.  Everybody's body is different and what works for me may make your headache worse.  Just my two cents.  Take Care and you may have to go through 15 different preventatives to find what works for you.  It is just the nature of the beast.

[jcmk1281]

Okay I have been thinking about this since my earlier post. The ativan that you are on can trigger rebound migraines, even though you are on a low dose that can happen with extended use.

I also agree with greenlydia, the baclofen is not used by any of the neurologists that practice in the three different groups that I help in as a patient advocate, at least not for migraines. So I would highly question continuing on that medication.

Midrin and darvocet should not be taken for more than 3 days a week to lower the occurance of rebound phenomenon.

Also if you have been on this current cocktail for a period of time without any improvement or worsening of symptoms you need to do a drastic shake up to your medication treatment. I actually had to stop all my medications for neurology and start from scratch. I am only on periactin and depakote for prevention and zofran and imitrex injections for treatment.

And try this for a month or so to see if there is any improvement. remove ALL aspertame, nutra-sweet, substances from your diet. there is a good possibility that removal of that food additive could lower the frequency of your migraines.

I would try that before removing caffiene from your diet since that is a more drastic change in your life.

And I know that you wont like this suggestion one bit. Go without the darvocet and the midrin for at least 2 weeks to clear your body of the pain medications. and that includes stopping all of the otc pain meds. you may need to get a fresh start so when meds are changed you can actually know what is going on.

I know that the above suggestions are not easy or fun but you really need to havea clean slate when trying to find a treatment plan that works the best for you

[RubyWitch]

WOW! I am not a doctor. (But I play one on TV) Sorry.............
In my very humble opinion, you are on WAY too many meds for your migraines! Maybe you've been through the entire pharmacy and nothing else has helped except this "stew of drugs" you're taking......but I would most definitely suggest you find a new neuro guy/gal and discuss reducing the amount. Have you ever tried Maxalt? It works well for me and a few other folks I know with migraine. Your sign in makes me think you're a nurse...........and IF you are, you know that combining so many meds can create more problems than they are meant to cure. As a nurse  myself, I have seen this far too often when docs keep adding more and more meds to combat what the last script has created and it's a very vicous cycle.  

One of the drugs you're taking, the Baclofen, has me baffled. Why are you on a drug that is usually given to people with MS or Quads? I have never heard of it being given to folks with migraine. It's a nasty drug and one I would ask some really serious questions about. I may be wrong. Like I said, I'm not a doctor  nor a pharmacist, but I still think you are taking too much. Please, for your own safety, get a second or even a third opinion from the very best neuro you can find, even if it means traveling a fair distance. Is there a good teaching hospital anywhere near where you live? My advice.....get your butt down there pronto. Good luck.
Greenlydia

[jcmk1281]

The depakote can help, but you may need to go up to 500mgs twice daily or 1000mgs twice daily. And another med is keppra that you can take.

[nrse1231]

I have already been on Topomax and I had a really bad reaction to the medication after about a week of being on the stuff.  In all honesty, I wouldn't reccomend anyone go onto that med, but that's just my opinion.  I have stopped taking the depakote as I developed a rash while taking the med, so here I am back at base one all over again.  I am so sick of these migraines that I want to scream!!!

[TinaGlende]

What dosage does the ER give you of Demerol for migraines?
Also for phenegran?

[specialmom]

Hi there.  This is an excellent question to ask your pharmacist.  Do you take these medications?

[LifesAHeadache]

One thing to watch about the depakote - it makes a lot of people gain weight.  It is an anti-seizure medication so if you start to gain a lot of weight - topamax is another anti-seizure you can try.

[noops01]

Hi,

There are two therapies for migraine one is abortive therapy and other is preventive therapy. Depakote is a preventive therapy medication. It is known to be very beneficial in preventing migraine attacks. So i would suggest you to try it out and see if it helps in reducing the frequency of your migraine attacks.Please remember that depakote will not help during the attack.
Also please do not stop this medication on your own. The dose has to be reduced gradually.It is known to cause drowsiness so please avoid driving and operating hazardous machinery till you are sure that the drug does not have this effect on you. Take care!