meds for migraines

[mrsp1]

Right now i am only taking Relpax for migraines. I have a headache almost everyday of the week and a migraine 2-3 times per month. I only take the Relpax during my migraines and may take tylenol, ibuprofen, or excedrin for my headace without any relief. My MD had spoken with me about taking medicine daily to prevent the occurence of my migraines. I really do not want to take another daily med because I want to have a baby in the next couple of years. The Relpax gives me really bad "jet lag" the whole rest of the day after taking it. Any suggestions? or what is everyone else on??

[marileew]

Oh. And one last thing. Yes... avoiding the preventative prescription medications AT THIS POINT does seem to be the best course of action for you since you are PLANNING to have a baby soon. The topamax that I am on can cause serious birth defects... there is a vitamin you can take daily, which I do take, in case of "accidents"... but, when one is family planning, if you can AVOID being on topamax, I think you are making a good choice... if you can't avoid being on topamax, do know that there is this vitamin you can take that will allow you to have a healthy baby. Ask your doctor about it.

The other anti-seizure medications you completely want to avoid. You also want to avoid the beta-blockers... very dangerous to mix those and pregnancy.

The anti-depressants are much less dangerous to mix with pregnancy. They might be a possibly option if some of these other suggestions don't pan out.

So yeah... I think that you are making a good decision and I really respect you for your decision. But, know that there are some daily migraine medications out there that you can mix with pregnancy if it comes down to it in the end... and know that even some of the ones that aren't that safe, like topamax, can be made completely safe with certain vitamins. :)

But... you're going to be a really good mom, already looking out for your child!! :)

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okay, that was a lot of information... but, I hope that maybe some of it helps a little bit...

let us know how it goes. I hope you start feeling better soon.

I have had similar headache patterns to you in the past and I know how extremely frustrating they are. I empathize and wish you all the best. I'll be thinking good thoughts for you!

[marileew]

Hi!

First off... I use zomig nasal spray for acute therapy. I use topamax 125mg daily for preventative therapy. I also use 400mg of B2 daily for preventative therapy. To supplement acute therapy, I use naproxen (a prescription NSAID).

As for some suggestions... yeah... what DrNoopurMD said!

Specifically:

- B2 @ 400 mg daily
- Magnesium @ 400 mg daily

if this does not help enough you could also try adding in

- B6 @ the recommended daily intake on the vitamin bottle as per government regulations
- B12 @ the recommended daily intake on the vitamin bottle as per government regulations

Also:

If you are finding that the relpax is causing unwanted side-effects, there are other triptan medications you can try for acute therapy:

- Rizatriptan, brand name Maxalt. tastes pretty bad, but a lot of my friends swear by it.
- Sumatriptan, brand name Imitrex. really not very effective at all in the tablet form. the most effective triptan out there pretty much in injection form... what they give you in the hospital. there is a new medication on the market called Treximet which is a tablet that works MUCH better than the Imitrex tablets because it is absorbed differently although it is the same drug by the same company... although, they really only created it because their patent just ran out so now there is generic, cheap, sumatriptan on the market... but, it's still a good thing because it forced them to find a way to make a tablet version that actually worked. so, don't get imitrex tablets, get the imitrex or generic nasal spray or imitrex or generic injection OR treximex tablets but NOT imitrex tablets.
- Zolmitriptan. brand name Zomig. this is what i use. (although i have used all of them at some point) don't get the tablets... like imitrex, the tablets don't work. But, the nasal spray DOES work incredibly well and this is what is usually prescribed anyway.
- Almotriptan. brand name Axert. a very powerful triptan tablet. does work extremely well in tablet form unlike some of the others... in fact, i don't think it comes in anything other than a tablet, probably because it doesn't have to. extremely strong. comes in two doses. i'd suggest starting at the lower dose if you were to try this... especially if you are experiencing side effects with the Relpax.

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NOW! Something you said that jumped out at me... you said that you have a headache pretty much all the time but only a few actual migraines a month...

so this means you have a "transformed migraine" ... basically, your migraines have become chronic and they have transformed into chronic pain. What you need to do at this point is to stop the pain cycle. You also need to avoid rebound headaches. So, it is important that you really focus on these two things.

First, you need to stop the pain cycle. You need to do this by finding a medication that really stops the migraine. It sounds like the relpax isn't really doing this... that hung over feeling might not really be a side-effect of the relpax, it might still be the migraine and the relpax might not be properly treating the migraine. It does not sound like you have 100% relief of your symptoms.

You might want to consider going to the hospital during your next severe migraine for a treatment of the following:

- injection with sumatriptan (assuming you have not already taken the replex)
- IV liquids (at least one liter i believe is the standard... but you can trust the hospital with giving you enough)
- morphine. this will make you feel sick and disgusting. if they say they are giving you morphine, ask for hydromorphone... it is more expensive (if you live in america, much more expensive for you... if you live in canada, more expensive for the hospital so you might get some argument but try to explain why you are asking for it instead of the morphine) if you are already experiencing a migraine, you will already feel nausea and sick to the stomach... the LAST thing you want is morphine side-effects, which are extreme nausea and stomach upset and vomiting... hydromorphone has NONE of these side-effects, so it is much better for migraine treatment. it is also a billion times stronger so make sure they do NOT give you any more than 2mg as a starting dose... otherwise you might end up feeling worse than when you first went into the hospital... trust me, being high is NOT fun. all you want is relief from your symptoms... opiate overdoses are disgusting. NOW, if you do live in america and cannot afford hydromorphone, then take the morphine they give you but ask for something like gravol to help with the symptoms... in fact, you might want to ask for gravol anyway... so:
- Gravol OR Metoclopramide (Maxeran) via INJECTION ... you'll just puke the tablets up if you're having a severe migraine. and, if they have you on IV liquids it is easy to add these to the IV. anyway. Maxeran ONLY works via injection anyway... it does absolutely nothing for the treatment of migraines if given by tablet. If for some reason you have already taken triptans and strong pain killers prior to going to the hospital, ask for maxeran, even though it is not a triptan or a pain killer, for SOME reason it can completely stop a migraine... they're not sure why (i don't think) but... it works.

^ now, after this, you will find that you are not in pain, or at least.. you shouldn't be. actually, after you are finally released from the hospital, the pain cycle SHOULD be broken. now, the important thing is to not let it start again. so, this means treating your next migraine ASAP with the triptan... don't wait until it gets bad, take it at the first signs of the migraine.

Also, do not treat your migraines with over-the-counter NSAIDS anymore. as you said, they do not provide you with relief... so there is no point in taking them. And, the problem with over-the-counter NSAIDS is they can cause serious rebound headaches... which could explain some of those headaches you are getting every day. Yup, pain killers could actually be causing those. But... I am not suggesting that you stop taking something if it is working... nor am I suggesting you stop taking the NSAIDS cold turkey or anything, that will put you into more pain... make sure you get out of your original pain cycle FIRST or replace the over-the-counter NSAIDS with an NSAID that is less likely to cause rebound headaches, such as prescription Naproxen.

[DrNoopurMD]

Hi,

You can try alternative treatments like biofeedback, magnesium and B complex supplements and acupressure which have shown good results in preventing chronic headaches.
The best treatment for migraine so far is identification and avoidance of triggers.
http://www.uhs.berkeley.edu/home/healthtopics/pdf/triggers.pdf

Thanks