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Butalbital and Esgic Plus for migraines (my story)

I've used Esgic Plus tablets for over 12 years for daily headaches, which often turned into vicious migraines. My family doctor gave me samples to try when Esgic Plus tablets first came out. Taking only one, with my usual 'four times a day aspirin doses' didn't get rid of the headache. It did dull the headache. Taken without the aspirin, the Esgic Plus actually set off the headache to a migraine. My doctor suggested always taking the aspirin an hour or so before taking the Esgic Plus, but sometimes I didn't have time to wait for the aspirin before I needed the Esgic Plus. Before finding the Esgic Plus, I'd gone thru all the Ergos, Fiorinal, and most everything to try and help these daily headaches. Nothing worked. But the Esgic Plus did dull the headache, and sometimes headed off the 'migraine' before it got too bad. My wonderful doctor suggested to me that I try Alkaselzer, or a BC Powder if I needed both the Esgic Plus and the aspirin quickly. That was genius. I love you Dr. Sykes. (I wish I'd bought stock in Alkaselzer since I use it daily several times a day.) Back then, I only took the Esgic when I got the three to four really bad headaches each month. My menstrual cycles made the headaches worse and more frequent as I got older. I'm 53 now. I'm sure they weren't rebound headaches from the Butalbital since I only took the Esgic Plus when I needed them. In my early 40's and with menopause lurking, my headaches became daily occurences for me. The occassional migraines became lurking monsters for me every single day. Anything that would or could be a trigger made the headaches worse. I'd done, and stopped everything possible, to keep the headaches at bay. The triggers were the usual foods and drinks that are known. Sleeplessness, or too much sleep. Getting upset or especially getting angry. BIG NO NO'S. DON'T LOSE YOUR TEMPER! Even barometric pressure could affect my headaches. (Oh no, another hurricane is coming, or more rain) It's a long list of 'what NOT to do.'  Not enough of, 'do this, or do that.'  I needed the Esgic Plus more frequently and was sent to a Neurologist at age 40 for the usual MRI. All was clear on the MRI. The Neurologist wanted to get me off the Esgic Plus, and suggested Ultram for me. He tapered me off the Butalbital slowly. I used only the Ultram daily. That did help some, but like the Esgic without aspirin, it didn't do much. I was told to stop the aspirin and only use the Ultram. I suffered, but still no more suggestions, except Imitrex. Also, by the way, if you"ll use a suppository, I used Tigan, that helps with the nausea. It also helps the headache from going into a full blown migraine. SOMETIMES. But it does help with the nausea. So the Neurologist gave me Tigan, also. That's four meds. He wanted me to use Imitrex every time I got a really bad headache that was turning vicious. Imitrex will actually trigger the migraine you're trying to avoid. Your stomach flips, and you're down for the count. I always wanted to wait before taking that medication and hate using it. Yes, it gets rid of the migraine within a few hours, hopefully, but you're still out of the game when you take Imitrex. My whole point here, is that I found a doctor that would give me the Esgic Plus, and the Ultram, and of course, the Tigan Suppositories. Those suppositories are a must for migraine sufferers. And I will tell you...I will stick anything anywhere to avoid a migraine. So there. lol  Anyway, the last 10 years I've taken one and a half Esgic Plus tablets, that's why you have to ask for tablets, so you can break them in half. In half a glass of water, I take three Alkaselzer tablets, that's one packet, and half a packet. (Alkaselzer Lemon Lime flavored) and one Ultram. Heaven. I found heaven. No more daily headaches as long as I could take my Esgic in the morning, first thing. Then again by that afternoon, or lunch. I get up around 6:00. Again by the evening, and before bedtime. That's a total of 6 Esgic Plus tablets a day. And 4 Ultram. So, about every 6 to 7 hours, around the clock, being sure to overlap the Esgic Plus and the Ultram with Alkaselzer. It sounds like a lot, and yes, if you stop it, or can't take it, you'll get the dreaded rebound headaches. I am addicted to the Esgic, or the Butalbital. But considering the options of taking that, or having migraines constantly, well, that's my only option. I do worry about the rebound headaches, and the fact that if I run out of the Esgic, I'm done for. So, my position on Butalbital, is this. PREVENTATIVE! If it works, when nothing else has worked, then it can't be any worse than being an addict with food, drink, or sex. At least I can have a life without wanting to blow my brains out everytime I have a migraine. And when I have them, that's exactly what I'm thinking. If I can think. Just take me out! Dark rooms, no sound, no light. Sitting upright. Don't touch your head to anything, which means, no lying down. Keeping your head level so that the pounding is distrubuted outward and evenly, which sounds crazy. As long as I have those three things, along with the suppositories when I know the migraine is coming, I'm usually OK. Now, the only times I really get the headaches are when I'm angry, upset, or crying. Then I know I have to calm down and get a grip. But without Butalbital I'd probably be a goner. I couldn't have put up with these headaches all these years. So, I know it's not a good drug for all things, or everyone. And if someone came out with something better, I would try it. But, I've only had a few really bad migraines in the past 6 years from not being able to control my emotions. If anyone has any suggestions, or gets any help from this, I would love to hear it. It's difficult to get a doctor to prescribe enough of the Esgic, and the Tramadol, (generic Ultram) so that it can be taken daily as a preventative. I've been reading on here, that most of the Butalbital is being controlled because of the acetaminophen, and the aspirin. Last month, I was given Fiorcet, and I take two of those, with my Alkaselzer, and my Tramadol. The Fiorcet, which is Butalbital, isn't the same as taking the Esgic Plus. Maybe it's just in my head, but doctors are reticent to give Esgic Plus these days. That's what I was looking for on this site in the first place. WHY CAN'T I GET THE ESGIC PLUS TABLETS ANYMORE??? My doctor even told me they were taking Esgic Plus off the market. That's why I started taking the Fiorcet. It's not the same. So now, I keep a dull headache, and wait for it to grow into a monster, depending on how my day goes. It was a great 7 years not having these daily headaches. But now, the doctors are afraid of prescribing Esgic Plus. It's not right. And yes, I read a lot of the other threads about people addicted to Butalbital. And I can relate to all of them. I'm always afraid I'll run out. Maybe the woman who always got angry when she took them was because she knew she had to have them, or be miserable with her headaches. If you take Butalbital, you don't get high. You don't feel anything different than when taking aspirin, or a vitamin. At least, I don't. I just don't have a headache. For those who have a bad reaction to Butalbital, I'm so sorry. I just know that it helped me all these years. And a quick suggestion to anyone who knows someone with Sciatica. The nerve in your leg that goes from your buttock to your foot with so much pain you can't walk. There's a new drug called Lyrica. If it wasn't for that, I'd still be in bed on a heating pad, and crawling to the bathroom. My husband's mother went down a month ago with Sciatica, and I was pushing for the Lyrica. They gave it to her, and did an Epidural, and after 6 weeks, she's getting around, and using a walker when she needs one. If you have Sciatica, you have to try Lyrica. It works. So does Esgic Plus for migraines. Good luck to all. Hope I helped someone.     Rosie
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Avatar universal
I also am am an Esgic Plus user. Let me tell you it really works for headaches. Unless you have had headaches everyday then you wouldn't know what really works.
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Avatar universal
ONLY FOR YOU, MAYBERRY...
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Avatar universal
Really???  If you don't like what you read here...it's on you to make a change!
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1135275 tn?1586565652
well said. glad you shared.

the only thing i'll add is that neither esgic or fioricet are federally controlled substances.
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Avatar universal
Rosie, first of all, I'm sure I speak for many of the people who use this forum as a lifeline when I say that I find it extremely insulting that you claim that (A)  Butalbital is not addictive, & (B)  Fioricet & Esgic are not controlled substances.  First, I'd like to point out that Butalbital is EXTREMELY addictive, even if not everyone becomes addicted.  Secondly, Fioricet & Esgic are classified by the DEA as controlled C2 (Class 2) narcotics.  If a doctor truly told you differently on either count, he should be reported to your State Board for review.  Also, if you have gotten generic brand prescriptions for Fioricet & Esgic, you should have noticed that both of them are named as Butalbital/APAP/Caffeine or Butalbital/Acetaminophen/Caffeine, depending on which pharmacy you use.  Understand this...they are EXACTLY the same medication, the only difference being the acetaminophen levels.  That is why Esgic has been pulled by the DEA (Numerous accounts of severe liver failure has been linked to the regular use of Esgic).  

I would like to share my story with you and the others following this conversation.  I suffered with severe endometriosis for more than 10 years before I had a hysterectomy 2 years ago, when I was 25.  I've taken fioricet since I was a teenager due to migraines I've always suffered and all it did was get rid of the headaches; it didn't get me high.  I don't know how or why, but one day I took my 1-2 prescribed pills & got stoned out my mind.  I was probably 18 or 19, and I have been, and always will be, horribly addicted ever since.  And let me tell you this, once the addiction took hold and I would get my prescriptions filled (45 tablets), I don't think they once last 3 days.  They make me absolutely insane.  I currently work at a Veterinary Hospital, and this is the first job I haven't destroyed because of fioricet.  I've had complete breaks from reality to the point where I thought and voiced absolutely ludicrous & crazy paranoid delusions, hallucinated, even physically assaulted family members.  I thank God that my daughter is young enough to forget the way that I acted.  Would I be able to take tylenol without going crazy if THAT was the reason for my issues?  I would bet my next paycheck the fioricet is what makes you so angry and completely without patience.  

Now when I wake up with migraines, I have to keep my eyes covered and feel around the house for the excedrin.  The bad part is, my liver is so shot from the years of serious prescription med abuse, if I don't take at least 3-4 at a time it won't help nearly as much, if at all.  

You said in your post "If it works, when nothing else has worked, then it can't be any worse than being an addict with food, drink, or sex.".  That is the worst kind of ******** I've ever seen on an addict's forum.  Do you have any idea how disrespectful that is to someone who struggles with this addiction?  Many people have destroyed their lives completely due to an addiction that gets such a grip on you it won't let go, no matter how much you fight.  This is forum is a LIFELINE for some of us!  For some of us, seeing that in a weak moment is all it would take to have us use your convoluted reasoning as justification to rush out and relapse.  You really need to be more mindful of what you say.  You obviously knew that this was an addict's forum & NOT the website for you to buy the pills.  

One more thing before I go, you should look deep into your heart & soul and admit what you won't admit to yourself.  You are an addict, and if you're not too afraid to be brutally honest with yourself, acknowledge that face and get help before you destroy yourself the way I almost did.
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1135275 tn?1586565652
and i feel compelled to mention that vicki may be spot on in her assessment. i was at one time convinced that i HAD to take the butalbital for my headaches. addicts can easily convince themselves they need a drug to function normally. an addict feels compelled to take their drug of choice by similar urges that make us feel compelled to eat and drink...it becomes a need we HAVE to satisfy, and so it becomes very easy to convince ourselves of a need for a drug when really the only need we're satisfying is that of an addict.

so yes, vicki could be right on the money. however, the only person who can know absolutely without a doubt for sure if you REALLY need this drug or you're an addict is YOU.

but please, don't come to this forum promoting the use of Esgic as safe and effective. the truth about migraine therapy is that barbiturates are the absolute LAST line of treatment when following the proper steps of therapy. there's a very good reason for this.
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1135275 tn?1586565652
well, now...i take offense to the part where you say that butalbital isn't addicting. for you, maybe not. HOWEVER, oxycontin ISN'T always addicting to people in SEVERE pain and have to take it every day. why? because they are in SEVERE PAIN. it isn't getting them high, it's helping them. keep that in mind! not everyone gets psychologically addicted to morphine when they use it every day. sure, they get physically addicted, like you are, but not always psychologically addicted. what i mean to say is i REALLY hate to see anyone say this drug isn't addicting when there are sooooo many people here that struggle with it.

ok, now i feel better having said that. moving on. esgic WILL be taken off the market. the reason is the amount of APAP (tylenol) that it has in it. the FDA has mandated that all drugs containing more than 325mg of tylenol be removed from the market, so by-by ESGIC plus. you will have to go with the fioricet. fioricet is exactly the same as esgic plus, however it only has 325mg of tylenol in it. to get an equiv. dose of esgic, you could add a 325mg otc tab of tylenol to your dose. heres the deal......6 of these a day isn't that bad for 1 day, but taking them like this EVERY day is really going to do a number on your liver. barbiturates and tylenol both are very hard on the liver. you really SHOULD attempt to lower the APAP intake.

Another thing.....this is rarely mentioned to people who don't go to specialists, but NSAIDS (aspirin) and plain tylenol taken every day DO have the ability to cause rebound headaches. this means if you tried going off the butalbital and still had daily migraines, but were continuing to take NSAIDS and tylenol, you could have still been suffering rebound migraines from those meds. it happens far more often than you would think.

now, unlike vicki, i don't have any harsh words for you for taking this med and saying it has saved your life. i have a soft spot for chronic pain sufferers....and IF you have gone through all the hoops and done everything that can be done without any relief, then just maybe this drug IS the right one for you to live a normal life. it's no different than when someone has to use opiates daily because nothing else works....for SOME people, there's simply no choice. triptans can't be taken every day and ergots are even more dangerous to take every day than triptans. are you trying topamax, though? depakote? lamotragine? there are all kinds of preventative drugs out there that CAN help....have you been through them all? propranolol helps some...topamax tends to get the best reviews.

here's the deal...this forum is for addicts. if you are here seeking help for addiction, then we could help you. you don't seem to be here for that. this being the case, you might benefit more from the migraine forum.

i hope some day you are willing to do everything it takes to find a drug that works BETTER for you than this drug. if none truly exist for you, then perhaps there's nothing you can do...however, the esgic plus really should go. that extra tylenol isn't doing a darn thing for your migraine.......all it's doing is shredding up your liver and possibly causing rebound migraines.

if you do not feel you have an addiction to this drug, then you would do better to try the chronic pain forum or migraine forum.
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1580085 tn?1400940838
No, No No !!! this just isnt right!! i would definately get a new dr. apart from the terrible addictions, your poor stomache/liver/kidneys, with all that aspirin/ acetaminophen!
i really hope ou see a new dr. and get some help, god bless.
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Avatar universal
As soon as I stop laughing I'll be able to post something intelligent here...then again,maybe not.

Rosie, you are addicted. I really feel sorry for you. Your epistle of a post helps no one here.
This is not a forum for what works great and feels like "heaven".

Not only are you addicted to butalbital but you're addicted to Tramadol. You have convinced yourself that these drugs are perfect for your headaches. In fact,they are causing your headaches...you poor thing. I wish you well and if you ever decide to get clean from this garbage...let us know.
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