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Migraine preventatives

(40 Posts)
RollerCola Mon 14-Jan-13 16:41:29

I've seen a neurologist about my migraines who has written to my gp with a suggested management plan. She has suggested a couple of different drugs to try as a preventative & I wondered if anyone has had any experience of them.

Firstly I've stopped (as much as poss) taking all non-prescribed painkillers as I was taking too much which was causing re-bound headaches. I'm trying to limit my sumatriptan to only bad attacks & I've stopped drinking caffeine as advised.

She has suggested either Topiramate (anticonvulsant) up to 50-75 mg or Pregabalin 75-150mg (not sure what this is but dh takes it for nerve pain)

I have previously tried Propranolol (beta blockers) & Amitriptyline but neither helped.

Has anyone tried these and did they work? If so what were the side effects?

Many thanks for any advice, I feel like I'm going mad as these headaches have gone on for years now. I just want them to go away sad

DoubleLifeIsALifeHalved Thu 07-Mar-13 11:54:25

oh how annoying, just went to gp to ask them to reassess the sumatriptan and all she did was take me OFF the pill and said they have to try that before trying anything else, even though i did say that I'd had the migraines far longer than i'd been on the pill, which I only went back on in the summer.

I'm sure its all true but ffs, why wont anyone do something about the migraines themselves? Grrrrrr.

RollerCola Sat 16-Feb-13 09:13:08

That's great Ice I'm so glad you've found something that helps as well. It's such a huge relief, I can't believe the difference it's made to my life. I would urge anyone who has regular headaches & migraines to push for a preventative - it seems they really do exist & work.

IceAddict Sat 16-Feb-13 00:25:26

Hi, so glad its working for you roller, i just want to say thanks for starting this thread! Without it i wouldn't have gone docs for preventative treatment, since starting pizotifen intermittently at the danger times, i havent had a single migraine. Ive been taking half the dose to see if i get results with fewer side effects. The only thing i have noticed is the odd visual disturbance which was really not much at all and an odd heavy head feeling at times I'd normally have pain. Could be psychological though! Overall I'm made up so thanks for the advice I've had even though i didn't post it grinthanks

RollerCola Thu 14-Feb-13 18:42:38

Hi, sorry queen I've only just seen your post. An update - I've been taking Topiramate for exactly 4 weeks now, including the end of one period and now one new period and it's been like a miracle for me.

I've only had to take one sumatriptan in all that time, and that was in the first week. I've taken no other painkillers at all. I've been taking 25mg daily up until this week when I started to feel a bit headachey in the week leading up to my period so I upped to 50mg. The side effects have been nothing more than pins & needles in my hands & a strange taste to fizzy drinks.

So all in all a great success grin

QueenOfCats Sun 03-Feb-13 23:39:50

Hi Roller - just wondering how you're getting on?

Have you increased you dose yet? How are you finding being on the medication?

Anyone else giving it a go? If so, let us know how you're getting on too smile

Mamuss Wed 23-Jan-13 23:19:20

I was prescribed pizotifen after getting a migraine every other day. I took 5 weeks to settle into my system and I had maybe 2 or 3 migraines in a year. I did put on 2.5 stone though! In a year! I've now weaned myself off them and have had 2 migraines since September, and the weight is falling off. I'd highly recommend it for the migraines if you can be very cautious about what you eat!

RollerCola Wed 23-Jan-13 23:11:21

Well I've been taking Topiramate 25mg on alternate nights since last Thurs & after initially being scared to death of the list of side effects, have had none at all! Not even the pins & needles or funny food taste that most people mention.

Up until today I had no headaches either. I got one this afternoon but it was my own fault for not eating properly. It's early days but at least I've not been landed with the side effects straight away. I'm going to up to every night soon & see how I go.

DoubleLifeIsALifeHalved Wed 23-Jan-13 20:32:44

I tried rizatriptan once a while ago & for the first time I took it it was amazing BUT then my migraines came back with a vengeance & the rizatriptan didn't touch them. I don't know why & I wasn't offered anything else so begged to be put back on sumatriptan ... Which they give in packets of 6 and I get through those in about 5 days. Argh!

TheOriginalNutcracker Wed 23-Jan-13 16:56:47

Iceaddict - UNfortunatly, my ds's migraines are pretty random. We've never managed to identify a food trigger at all. The only things that I knew can trigger one is anxiety, hot weather, over exctiement and too much screen time.

I tried lowering the dose in the last summer hols but they started back up again with avengance.

Iceaddict Wed 23-Jan-13 11:40:56

Nutcracker, my doc advised 1mg pizotifen before bed for around 6 days when I think the hormones are kicking in. I've not tried them yet, I'm going to monitor my cycle and get it spot on for the best chance of it working. My leaflet advises maximum of 4.5mg a day for adults so its a low dose in also taking phentermine so hoping this will counteract the tiredness and weight issue.

Has your GP identified your sons triggers? Maybe you could try what I'm doing and take the higher dose but only during the time it's likely to happen. (Completely not sure about this but maybe an idea)

Sorry your son has migraine hmm how unfair. Poor thing, growing up is tough as it is

Iceaddict Wed 23-Jan-13 11:26:04

Double, your go should be doing more. Pain killers are rubbish for migraine. I know sumatriptan is for migraine but have they discussed rizatriptan with you. If you can't have a preventative then surely rizatriptan would be better as you take one on the onset of a migraine and its gone within the hour. For me it is anyway. Only prob is I feel foggy and tired for a few hrs but its better than the pain.

LadyKinbote Mon 21-Jan-13 19:45:28

<writes down Topiramate and makes note to see the doctor>

Mine have been terrible lately, 10+ a month. I've never had any luck with preventative treatments but will give this one a go!

TheOriginalNutcracker Mon 21-Jan-13 19:39:31

15ml, not 5ml

TheOriginalNutcracker Mon 21-Jan-13 19:37:24

Just butting in to say that Pizotifen is good, but it is also an appetite enhancer. My ds is 10 and takes 5ml of pizotifen nightly, and has put a lot of weight on.

The doc wants to put it up to 20ml as ds is still getting migraines, but I am worried about him putting more weight on, so we are going to leave and wait and see for now.

DoubleLifeIsALifeHalved Mon 21-Jan-13 19:31:08

ooh this is interesting, if anyone's still around can you tell me more about Topiramate? Can you take it with a whole host of other drugs - Fentanyl, Amiltriptaline low dose and venaflaxine?

am just taking sumatriptan like they are sweets and can't get my gp to think any further about the migraines as i have another condition too, hence all the pain killers, so she doesn't want to prescribe anything more. Not terribly helpful as when I've seen a pain consultant he said the GP should really be addressing the migraines... I have about 1 a week at a minimum, and its hideous living like this.

Iceaddict Mon 21-Jan-13 10:49:55

Hiya, don't know if anyone will see this now but just managed to see doc. Got rizatriptan wafers for migraine same as usual. But he said to try pizotifen. It's an antihistamine or antiseretonin agent. As my migraines are linked to hormones, I'm to take four days leading to ovulation or period up to 2 days past the danger time.

Asked about other drugs mentioned here but he wants me to try this first as there are far fewer side effects.

May still get odd stress/tiredness/alcohol related ones which I can take wafers for. Will report back if anyone wants to know

QueenOfCats Fri 18-Jan-13 20:21:11

Everything crossed for you!

Keep us posted grin

RollerCola Fri 18-Jan-13 20:14:37

Thanks, she said I could go up to 75mg if I needed to but I'm hoping that the lower dose will work. It may just be wishful thinking but my head feels quite 'clear' today. Most days even if I don't have a headache I get a dullness that never really goes away. Fingers crossed.

QueenOfCats Fri 18-Jan-13 19:26:02

Well done roller! smile

Really hope they work for you!

The eye thing I would try not to worry about. More common at higher doses and becomes apparent quite soon after starting the tablets.

I felt a bit dopey for a couple of days after starting mine - but nothing too bad. Or that anyone else noticed. I did seem to struggle to find certain words on occasion but that passed completely after a few weeks.

I started on 25mg every evening for 2 weeks then added 25mg in the mornings too - I didn't feel right do dropped back down to 25mg at night only and that's fine for me.

Don't aim for a particular dosage. If I remember correctly, there's no evidence that a daily dose of over 200mg is effective for migraines.
You have to find the dosage that gives you the most relief and then stick there.

Good luck!! grin

RollerCola Fri 18-Jan-13 19:15:09

A quick update, I saw the dr yesterday and she's given me the Topiramate. I've to take 25mg every other night for 2 weeks, then every night, then 50mg.

The list of side effects is VERY long and I'm quite nervous about taking them. The main ones I'm worried about are feeling dopey & the eye pressure (I have a family history of glaucoma) The dr only mentioned pins & needles and drowsiness.

I took the first one last night & so far so good. No weird effects today and no headache grin. Hoping it lasts!

alto1 Tue 15-Jan-13 20:15:51

I don't know how people can manage with two a month, let alone more. Mine are only every few months on propranolol and valproate. It's not worth my taking topiramate - but when they break through, they come in series so I can lose up to five days.

Can anyone point me towards the best migraine forums? My online life is fairly limited but I would like to get on top of this.


RollerCola Tue 15-Jan-13 19:57:26

Does anyone know if it makes any difference as to the effectiveness of topiramate if migraines are hormonal?

shitmagnet Tue 15-Jan-13 11:10:14

Message withdrawn at poster's request.

Iceaddict Mon 14-Jan-13 22:20:52

Thanks I'm doing good on the weightless anyway so wouldnt go on it just for that but it would be a bonus may help hormone levels to I think.

QueenOfCats Mon 14-Jan-13 22:14:53

Iceaddict - topiramate is mainly used as an anti-epileptic. But it has other off licence uses too, one being weightloss. Many people are prescribed it for weightloss alone!

If you google topamax weightloss you will get some info on it.

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