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1088430 tn?1259159773

Best RX/Solution for Migraine Prevention?

(Sorry in advance for length; from desperation)6yr hist. what thought was "chronic sinus headaches" that triggered handul migraines per month.4yrs ago rough patch chronic migraines lead to 4 months worth doc appts, ct scans, mri, neurosurgeon ref, due to what they thought "AVM".Artialgram b/f laser surgery showed "not there".Thankful, but so over all that wasted dead end time, cancelled foll up with reg neur. for "migraines" & have dealt on own till recently.The chronic headaches would be mild-mod, handful migraines mod w/couple a yr "severe". Stayed mild-mod light sensitive 24/7.(Realize now should have gone back MUCH sooner & I probably had myself on a bad cycle of going into "rebound" headaches as well as "real" stuff b/c of the frequent use of over counter meds.)Lesson learned;4wks ago hit rough patch chronic sev migraines l(ike 4yrs ago).Pushed me back to doc, he said "clusters" gave steriods 1st (no help)then Fioricet(no help).Stopped those two, sent to neur.Gave relpax shot in office (ist relief EVER in wks!)relpax rx,temp. toradol rx to get through "rough patch" and nightly "anti-depressent" for nerve pain.Trying to not overuse anything to avoid "rebound cycles".However, already went through relpax for month & even though I'm living like a vampire to prevent as much as I can dealing w/UBER light sensitivity(not driving myself to work/home while wearing sleeping mask in passenger seat,eating in dark kitchen while family in lit dining room,showering/bathroom in low-no light,ligths voer computer at work unplugged and screen dimmed to 20%) I'm still suffering with almost all day long "nervy" pain in diff patches on my head diff times (typically on top or left sides, never right) (feels like scalp is off sometimes and nerves are exposed) when no choice but high light exposure (some work situations, no choice but to drive myself, etc) it'll slip into a full blown "head on concrete/injury" migraine headache pain almost still once daily/every other.Trying for "mind over matter" & many,many self management things w/ no success.Next neur. appt coming soon.Pls give advice on what's the best to ask him about concerning prevention RX.MAIN trigger is LIGHT. Main concern is the burning nerve pain & headahce pain. Only rare that I get "auras" & sick stomach.Again, sorry so long!
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1088430 tn?1259159773
I just want to say THANK YOU SO VERY MUCH! for all the time you have taken in offerring your advice! I can't tell you how much it's appreciated! I'm so sorry that you have been dealing with this (xcuse the vulgar word coming) **** for as long as you have! I truly sympathize. It's a very unselfish and great thing that you have extended yourself from your own painful bouts to try and help others (like me). I believe in how the good we do always comes back to us. I appreciate you mentioning Topamax, that's the main thing I kept reading about doing some research. However, hadn't heard from anyone "real" if it actually worked or not. Seeing the neur again this Friday w/that request at the top of my "wish" list. Past two nights have been so much hades from the pressure laying my head on my pillows, that the pain kept me more awake than asleep.It escalated into a masive migraine waking up yesterday am, but only what I'd say a mid size one this am. The funny is that it hurt so bad last night it made it into my dream. In dream, was walking around taking Advil every so often and getting mad that it wasn't working (ha). Part of the misery lately is probably my fault, but for a good cause. I've read so much about "rebound" headaches from too much meds and have had my "come to Jesus moment" with myself on how since I allowed myself to take SO much ongoing over the counter stuff these past couple of years trying to deal on my own, I wanted to make sure that I was as "rebound free" as possible these past two weeks before seeing the neur again. Since I went through all the relpax (gold in a pill), I've only allowed myself to take one dose of either advil or excedrine a day and one of the "dopy" painkillers he gave me (besides the two "nerve pain things at night which arn't doing a dagum thing). The dopy painkiller really does nothing for head either. Honestly, it just dulls me mentally enough to handle the "pain" better. Only three pills left of that stuff and will ask I'm never given it again. I hate "dopy" stuff. Thanks for the suggestion on the nerve stuff. I've thought that too, will explore it more with him. My mom has an xtemely hard time with "restless leg syndrome" and has vowed that since that is nerve related, I probably am affected by something similar because of genetics. However, she's a bit "drama queen" about things to the point I've not really taken her suggestion seriously. Again, thank you for your time and good intentions to help other people (:
Helpful - 0
768044 tn?1294223436
Hi FurballsMom!

Thank you so much for linking to the group! :) :)

- marilee :)
Helpful - 0
768044 tn?1294223436
Hi there!

I am personally taking topamax (anticonvulsant) and nadolol (beta blocker) daily as well as botox injections every three months.

I have found the topamax to help reduce the daily headaches although it has not reduced the number of acute migraine attacks, I have been on the topamax for a while now. I am not sure if the nadolol is working, but I have also only been taking it since August so I cannot say for sure how effective it is. I believe that the Botox has helped, as I got my first injections early this September, and September and October are usually some of my very worst months and although I have had some very terrifying migraines this September and October and although my migraines are still chronic, comparing this year to last year is like night and day... I spent most of last autumn in the hospital and so far I have basically avoided ER trips this autumn.

I also take some daily supplements too. I am currently taking anywhere from 300mg to 600mg of Magnesium citrate a day. The recommended dose for migraine prevention that has been proven in scientific trials is 400mg per day (in one trial) and 600mg per day (in another trial)... so, basically, I think that if 400mgs works, then that's all you should take. But, some people find that more is helpful, or sometimes people's doctors will prescribe more. The other daily supplement that I take that has been proven effective at preventing migraines is 300mg of Coenzyme Q10 a day.

400 mg of Vitamin B2 has been shown very effective at preventing migraines in scientific trials, although this in not currently part of my treatment plan. But, I think it's worth a shot for anyone who hasn't tried it before as long as they clear it with their doctor first.

Medications that I have tried in the past that I have stopped have been Amitriptyline (antidepressant) and Valproic acid (anticonvulsant). These did not work for me, but there are many people on these forums that I know who are currently taking Amitriptyline and who find that it works very well for them. I would not discount either of these medications as options to try, even though they did not work personally for me and I personally found Amitriptyline to have too many unwanted side-effects. Both of these medications have been shown effective in clinical trials and I know people who have found them helpful, so... I can't discount them as very worthwhile options.

The fact that you mention burning nerve pain as well as migraines makes me think that the burning nerve pain could be a comorbid condition instead of directly connected to the migraines. Is this the case or a possibility? If so, do you know what the burning nerve pain is caused by? If it is not caused by the migraines and you do not know what it is caused by, some suggestions are Fibromyalgia or some form of Neuropathy. If you think this is a possibility, then which medication would be best to use a preventative might be narrowed down depending on which comorbid condition was causing the burning nerve pain as different medications will address different types of nerve pain differently.

One of the preventative migraine medications that I am currently taking, Topamax, is often prescribed for neuropathic pain. A friend of mine was completely disabled by neuropathic pain until she began taking topamax and because she takes topamax she can walk and use her hands... so it's pretty amazing stuff for neuropathic pain. So, topamax might be a good choice for you to address both issues of nerve pain and migraine pain.

But, if this is a Fibromyalgia sort of nerve pain in your head, a tricyclic antidepressant might be a better preventative treatment. So, maybe Amitriptyline, Nortriptyline or Protriptyline.

What it really boils down to is that it's all very individual and personal.. what is best for one person may not be best for another person. There are some things that doctors prescribe that are just plain ridiculous in my opinion if they really are for the prevention of migraine headaches. I do not believe that SSRI antidepressants are effective treatment for the prevention of migraine headaches but I've heard of people being given Effexor or Paxil for migraine headaches, which makes no sense to me as such drugs have not been proven effective at preventing migraine headaches and side effects include an increased risk of headaches... mind you, that is not to say that a migraine patient shouldn't take such medications if needed, because these are life saving medications in cases of depression... but if a migraine patient happens to be prescribed a necessary life-saving medication for a non-migraine disease, they should still absolutely be prescribed proper medication for their migraine disease as well. Also, there are a few Beta Blockers and a few Calcium Channel Blockers that have more risk associated with them than benefit... but those aren't often prescribed anymore... only the safe Beta Blockers would be prescribed. So, really... out of the majority of the medications prescribed these days for the prevention of migraines, it's really sort of a lottery which one will turn out to be the best for you. But, a good place to start, in my opinion, is with the one which your doctor thinks will work best, and then from there to try one from another one of the three classes of daily preventatives, until you've tried one from all three classes of daily preventatives, that sort of narrows it down anyway.

Hope that helps some? Hmm... sorry I couldn't give you a simple answer... I really wish I could, I'd love to know which medication was the best too.

Also, I see you've joined the Migraineurs Support Group! I'm glad you joined! I'll look forward to seeing you in there! :)

- marilee
Helpful - 0
681148 tn?1437661591
I'm still trying to figure out the right solution for my migraine issues.  I have less experience with treating them than other people do.  Long story there.  Anyway, I would suggest joining the Migraineurs Support Group.  The lady who started that one really suffers herself, but as she has dealt with this her whole life, she is very knowledgeable.

http://www.medhelp.org/posts/Migraineurs-Support/Welcome-to-the-Migraineurs-Support-Group/show/1062435
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