Migranes

I have been suffering from migranes (migraines) for 25 years now and have been using Imitrex successfully to relieve the attacks (usually several times a monthy, primarily around the time of my menstrual period). in the past year, i have been suffering EVERY day (for weeks now) and have had to take IMITREX every day to relieve the pain. upon consultation with a neurologist to resolve this addiction, she put me on ELATROLET (20 mg a day) and it worked for a while but after 2 months, the daily migrane (migraine) attacks returned. i am glad to have IMITREX to relieve my pain but am aware of the fact that i've become an "addict" - it's the only thing that helps. i would very much like to reduce my intake but don't know how.

[Dr. Kokil Mathur]

Hi
Welcome to the forum!
Since you have a headache almost daily, what you have is in all probability not a simple migraine but a chronic daily headache (CDH). This can be the primary type—without any cause. If the headache lasts for less than 4 hours then it could be a chronic cluster headache or a chronic paroxysmal hemicranias. If it lasts for more than 4 hours it could be chronic tension headache, chronic migraine or altered migraine or hemicranias continua.
The CDH could also be secondary to trauma, raised intracranial hypertension, high blood pressure, cervical disorders like pinched nerves, temporal arteritis etc.
Hence apart from medicines it is important to rule out various causes of headaches. You should consult a migraine and headache specialist.
There is a similar discussion on MedHelp which may interest you: http://www.medhelp.org/posts/Neurology/DAILY-HEADACHES-MIGRAINES/show/294752
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!

[marileew]

Hi jcovaliu,

Lots of us here on the forum suffer from chronic migraines, so we can really sympathize with you. Many of us have tried multiple preventative medications before finding the right preventative medication that worked for us. The Elatrolet you are taking is a preventative medication, it's generic name is Amitriptyline. Amitriptyline belongs to one of the three main classes of daily preventative migraine medication:

- Antidepressants (Amitriptyline, like what you are currently taking)
- Anticonvulsant (Topamax or Valproic Acid)
- Beta Blockers

Neurologists also use Botox, but not daily, as a preventative measure against migraines. Botox is injected every three months into the face, head and neck.

If the Amitriptyline is not working after a three month trial, it is time to try something new. You should discuss with your doctor about switching to one of the Anticonvulstants or one of the Beta Blockers. You may also want to discuss trying Botox, although this is not usually covered by health insurance so many people wait until they have tried every other option first as Botox can be an expensive option for some.

Now, I want to address this idea of you being an Imitrex "addict". I do notice that you use the word addict in quotation marks, so I do think that you just mean you don't want to have to rely on acute medication to control your migraines, which really just means you don't want to have so many migraines, it has nothing to do with the medication at all... and I understand that completely. Having so many migraines is awful and no one wants to have that many and I am really sorry you're getting that many... hopefully some of the information I've provided about different preventative options will help in terms of talking to your doctor about different preventative treatment options and then you won't get so many migraines.

But, just in case you were genuinely concerned about becoming addicted or even just physically dependent on Imitrex, I'll address that as well. If you were using a narcotic medication to treat your acute migraine pain, I might entertain the idea that you were becoming physically dependent on your pain medications, although that is quite different from becoming addicted... even in the case of narcotic pain medicine, it has been proven time and time again in multiple studies that those who suffer from chronic pain are at a very low risk of becoming addicts, even if they must use high doses of narcotics daily to treat their pain. But, in your case, you are using a completely non-addictive drug and a drug that your body cannot become dependent on... it's not even like SSRIs where it is possible to become dependent but not addicted, because with SSRIs, they don't provide any "high" so there is no reason to become an addict or to crave the medication, but ones body will still become highly dependent on the medication to a point that if you take the body off the medication abruptly you can cause seizures and even death... Imitrex is NOT like that!! Imitrex does not cause any sort of high or euphoria so you cannot become addicted to it, you will not "crave" it when you are not in pain... also, if someone offered you a medication that worked as well as Imitrex, you would probably use it when you were in pain as a substitute for Imitrex... which all shows that Imitrex is in no way addictive. As for physical dependency... well, I have heard of the triptan Maxalt causing rebound headaches, which could be considered a type of physical dependency maybe... but, out of all of the triptans, the ONLY triptan that has shown this is Maxalt, not Imitrex. So, Imitrex is not a type of medication that you can become dependent on physically. So please don't worry about becoming dependent on the medication!!! Use it when you are in pain if it works!! Please do not suffer because you are worried about becoming dependent on a medication you have no chances of becoming dependent on.

The only thing you have to be careful about dose wise when using Imitrex is that you only ever take as much as your doctor has prescribed for you, and you never take more than 2 doses in a 24 hour period unless specifically instructed to by a doctor or if you are administered those doses in a hospital setting and that you never take more than 2 doses for the SAME migraine. Otherwise, please take the Imitrex when you are in pain, you have nothing to worry about addiction wise. Your doctor may suggest that you cut back on the amount of Imitrex you are using, because it is not ideal to be using triptans on a daily basis... but, you need to have an alternative medication that is NOT an over-the-counter pain medication, as such a pain medication WILL cause rebound headaches which will just make the situation worse. A possible suggestion is a prescription NSAID called Naproxen... but, too much of this can cause rebound headaches too, just less likely then the over-the-counter stuff... so, you could maybe, if your doctor thought it was a good idea, mix up your treatment plan by using Imitrex sometimes and Naproxen sometimes, IF the Naproxen worked. Otherwise... talk to your doctor about other non-triptan options for pain control. AND... most important, get your doctor to switch you to a new preventative, because the ELATROLET isn't working for you (it didn't work for me either!).

[carolyn4129]

Your situation sounds similar to mine.  I take Keppra, an anticonvulsant, Vivactil, an antidepressant and Inderal, Blood pressure medication to prevent headaches.  I still suffer almost daily headaches.  When I take 50 mg of Imitrex (daily) the headache is gone within an hour.  Dr. says I take too much Imitrex,  but without it I am curled up in a fetal position, in a dark, quiet room, trying not to move for 12 hours...  I am so worried that the Dr. will quit prescribing Imitrex (one already did) and I will be left without a life... I don't know what to do.