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Migraines and Headaches Community
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Avatar universal

Bigger Migraine, Bigger dosage?

I'm 15 years old, and a little over six months ago, I was diagnosed with persistent migraines. The doctor prescribed me 10mg tablets of Amitriptyline, which I take every night, and my dosage has not been changed since then. But for the past few weeks, I've noticed that my migraines have gotten worse and the medication does not seem to help. Usually one of my severe migraines is caused by exposure to bright light or strong odors, but lately they are just coming at random times and for no reason. I was wondering if I should just ask my doctor if I need a higher dosage of medication, or if something else could be causing these migraines?
Thank you!
10 Responses
681148 tn?1437665191
I would consider asking if it might be time to try something a little bit different.  Fifteen years old makes me wary about what to suggest, because young people are much more sensitive to the SSRI medications.  But, I do know that the neurologist told me that Amitriptyline is the strongest of the Triptan medications.  I am leery of stronger dosages of that, since it's still an SSRI medication.  It is known that doctors have to be very careful with this kind of medication with teens and young adults.  My neurologist had me quit and try something entirely different, but I don't know how the medication he had me start using at night would affect someone as young as yourself.  So, I'm a little hesitant to mention the name of the medication.  The pharmacist said it was a type of muscle relaxant.  And, actually, the doctor has me taking HALF of the lowest dosage they make at night.  This is partly due to the fact that the big muscles across the neck and shoulders are always as tight as a drum.  If your doctor thinks this is a good idea, he should know the name of this medication himself.

It ***** being born with this type of illness, doesn't it?  Even though I was unaware of all the silent migraines I was having my entire life, I did still have other types of headaches and migraines, because I was born with this, too.  I know how awful it is to feel so horrible at such a young age.  I also know it must really rot to keep getting told that this or that medication treatment you've heard about is being used in adults but the medical professionals keep holding back with treatment protocols because of how young you are.  I know that has to be very frustrating.  The only thing I can say about that is that at least you can't regress in age, so eventually they will stop telling you this and try various other treatments which they've held back.  And, they will probably stop at a younger age than most, because they will have to do something to help you.  Right now, they have to play it safe.  Doctors can get in serious trouble if they use a treatment not approved for young people or if they don't follow protocol that says they must really watch for various issues with young people.  I mean, even commercials for Lyrica have to say this, because Lyrica is also an antidepressant, even though it's advertised to be used for Fibromyalgia.

In a few days the neurologist is going to try Botox for the first time with me.  He said that Botox is very expensive and he doesn't even attempt it until the insurance clears and it is fully authorized by the insurance.  This is very interesting, because when I was your age, Botox injections were strictly cosmetic.  The only reason I even knew anything about Botox injections when I was your age was that people joked about it.  The reason it's being used for pain and migraines these days was that many who were using it cosmetically noticed a reduction in their migraines.  The neurologist explained that at first, there was no real protocol about where to use the injections, but now there is a protocol, because they understand where it is best to use the injections.  

You have to meet the criteria before insurance companies and doctors will authorize Botox.  I don't know if they do Botox on someone as young as yourself.
1686558 tn?1309286166
I'm sorry your migraines have been so bad!  There are a lot of different treatment methods and different types of drugs.  It may be that it was effective for awhile but your body has build up a tolerance and it isn't so effective any more.  The solution may be to try a different type of medication.  There are like 6 different families of migraine meds, so if one type stops working, there are more.  My best advice is don't accept migraines as permanent, and keep fighting for solutions.  If one thing doesn't work, move on and try different things.  
The thing that's so crummy about migraines is that they affect every aspect of your life, and the most effective method to tackle them is from all directions.  Eat well, take vitamins, try yoga or meditation, medication, etc.  I've heard good things about biofeedback and acupuncture/accupressure but I haven't tried either one yet.  You're 15, which means your hormones are likely to be playing a big role as well; when I first started getting mine at age 11, I was getting them like 3-5 times a week.  But as I aged through puberty and tried new medications, I got them under better control.  Good luck and stay strong!
681148 tn?1437665191
Definitely be careful about what you eat!  I don't know if your doctor told you to research Tyramine Intolerance yet or not, but definitely do that.  Removing the worst culprits from the diet will definitely help.  This is what the neurologist told me, because he said that people with migraines have Tyramine Intolerance.  Blood tests don't confirm Tyramine Intolerance.  But, you can easily figure this out for yourself by keeping a food diary.  After you read up on Tyramine Intolerance, you'll know more which foods to avoid.  Some of them are actually listed on the migraine tracker, which helps to confirm that these foods really are things we need to avoid.  Some of us are more sensitive to these foods than others are, but the bottom line is simply to be aware of which foods are most likely to cause migraines.
Avatar universal
I saw your comments about Botox.  Botox has helped my 24/7 severe migraines a lot. It costs more than $7,000 each time I get them.  I can also purchase it myself at the pharmacy and take it to the doctor to inject.  Then the total cost is the price of the Botox, about $850 to $1300 and then just the doctor appt., but then I'm stuck with the price of the Botox since my insurance doesn't cover non-self administered medicine.

We've been fighting the insurance company for months and are now waiting for a response from our State Insurance Commission who may force the insurance company to pay for it.  If that fails we plan to sue the insurance company to pay for it.  That's how helpful I found the Botox to be.

It's absolutely ridiculous that it is not covered since the FDA approved Botox for migraines on October 15, 2010.  There are also many studies that have showed that Botox helps migraines greatly.

I really hope that you can get the Botox injections.  If the doctor starts at 100 units, they can increase it to 200 units which is what I needed to help me.  They do hurt quite a bit, but much less pain than my migraines.    
Avatar universal
I'm sorry that at 15, you have these migraines. I'm 33 and I have terrible headaches as well. But you also have to balnce school work and every thing else that comes with being a kid. I hope you find some relief soon.
Avatar universal
I got my first migraine at age 9, and then started getting them at a regular basis when I was 14. I'm 22 now and I'm starting to deal with a whole host of problems associated with them - I actually just found out that in addition to my ocular migraines I was born with a spine problem and crowding around my brain stem. I hope you don't have to go down my road but if you do then hopefully you'll be blessed with a supportive family and great doctors like I have! I hope that my experiences can help you some - I was blessed to have a wonderful neurologist who has been helping me out for years.

You say your doctor prescribed the medicine. Is that a neurologist or a general practicioner? First and foremost, if you're not seeing a neurologist you should. Also, as a passing thought, since you're a girl you could be getting migraines as a result of your menstrual cycle. It's not something to discredit and definitely something you should talk about with your mom/dad and with your doctor. Some women who get migraines starting at our age get them because of problems with their ovaries, most notably polycystic ovarian syndrome which I was diagnosed with when I was 20. If you have menstrual problems too, make sure to bring that up at your next appointment. Who knows? There might not be a correlation in your case, but there could be as well. It never hurts to ask a question.

Something you should be aware of with triptans is that if you take them too much, you can actually get a rebound headache from the medicine itself, which means that you have to take more to get the pain to go away and then it turns into a vicious cycle. Think of it like an energy drink crash, except more painful. I went through that and my doctor ultimately put me on a preventative medicine (which is called a prophylactic medicine) to help keep them from coming. That helped a lot and it kept my migraines under control for about five years. There are several kinds of those medicines: beta blockers, calcium channel blockers, anticonvulsants, antidepressants, and a few others. I've always felt that preventing a migraine is much better than treating them so that might be something else to consider too.

And to echo the other sentiments shared, diet and careful exercise, vitamins, relaxation techniques, and even alternative medicines can all help out too. Just do your research and talk to your doctor and you can always pop back in here with questions! Hope I could help!
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