Is there any migraine medication...

[EsterOdesavitch]

...that doesn't leave you utterly wiped out and good for nothing?!

I've suffered chronic migraine for 20 years, but it's manageable with prophylactic propranolol, and more recently I finally scored sumatriptan plus metaclopramide for when one takes hold. Why they couldn't have offered me that years ago I don't know.

The sumatriptan is good for clearing the pain within an hour or two, but the side effects have been worsening lately - the constricted sensation in my throat and painful swallowing, the numbness in my face and the bleary, drowsy, unable-to-think-straight effect wasn't conducive to getting on with my work (WFH full time at present).

I asked for Rizatriptan as an alternative, and tried it for the first time yesterday when I abruptly developed a cracker out of nearly nowhere (went from a mild pain that might have faded away on its own, to a crashing migraine in a matter of minutes).

Again it was good for the pain, I laid down and listened to some music and it cleared it within 45 minutes (brilliant!) - but found I then couldn't wake up properly, speak coherently or even stand and walk very well. I kept trying but had to go back to bed, plus it plunged me into a very dark mood. After 3 hours I managed to stagger downstairs but I felt "out of it" for another hour or so.

Sadly the pain is back today (hasn't floored me yet, maybe it'll fade) and I have 3 giant reports to write.

Are there any alternatives to triptans? I know I can ask my GP but I seem to be contacting them a lot lately, and sometimes the collective knowledge and experience of MN is better...gives me a solution to approach them with!

I'm a sufferer from much milder migraines than you so I'm not sure about the drugs, but I know that the after effects of the migraines leave me blurry and not-with-it for a day or so.

Is it the drugs or the migraines that are giving you the 'out of it' feeling?

Have you seen a neurologist OP? I got referred a couple of years ago with migraines as they were getting bad and nothing the GP tried helped. My neurologist put me on venlafaxine which is actually an antidepressant But there has been several studies showing it as good migraine prophylaxis. Venlafaxine alongside propranolol works wonders for me! The neuro also recommended a riboflavin (vitamin b2) and a magnesium supplement following some recently published research. There is also a probiotic called migrea which I took a course off (you can get this online and the research is quite promising) good luck!

Do you get auras? Have you tried topiramate? You have to take it every day though. (I live in Aus and prescriptions are different here.) Side effects include loss of appetite (I wish I had that), memory issues (I grasp at words when stressed), etc... it definitely keeps mine at bay.

Don't think so. I'm on topiramate for migraines. It caused me weight loss in the beginning (sadly all gone back on now), changes my sense of taste so random things taste weird, bitter, mouldy or just wrong. It can cause gallstones/kidney stones (I forget which). Link with memory loss/reduction in cognitive function. Can cause at least 3 serious birth defects if taken during pregnancy. Hair loss. Lots of other crappy stuff. It is pretty effective for some people, but some can't cope with it. All drugs have side effects. I couldn't cope with amitriptyline or candesartan. I tried coming off topiramate due to the side effects but my migraines were absolutely intolerable & life is much better with it.

I take sumatriptan. I take one then have to go and lie down for a nap in a dark room for an hour or two. No other side effects so far, have been taking them for around 8-9 months now, 3 or 4 times a month (hormone/perimenopause related migraines)

I’m on topiramate just now too, just taken it actually. It’s the best one I’ve found. Amitriptyline made me a spaced out zombie and the others didn’t really help.

How often do you have them? Might you need a preventer rather than a treatment? I take amitriptyline and it’s cut them down massively. It made me really sleepy for the first week or two, but that wore off pretty quickly. I took it at a fairly early time in the evening for the first few weeks, so that I would be reasonably awake in the morning, and now I can forget and take it as late as 11pm and still be awake at 6am and ready to go.
Hope you find something that works for you.

To try and answer some questions - this is definitely the after effects of medication, as I'd had migraines for 18 years before anyone suggested triptans! I do feel a bit "wonky" after a migraine without drugs, but not like this. In the past I could go several weeks without getting one, but lately it's been 2 or 3 a week - stress at work I think.

No aura. I took amitriptyline alongside propranolol for many years, until a GP noticed that I already take another AD (Lofepramine) which effectively works in exactly the same way, so he took me off the amitriptyline and I was only on 10mg anyway.

Never tried topirimate? I have just started a vitamin B complex for perimenopausal brain fog - started HRT 6 months ago.

I've been working this morning hut this headache js starting to eat through my eye socket

Sumatriptan worked for me, but made my whole left side go numb which was disconcerting.
I eventually bought a Cefaly device and that's been a godsend. Unfortunately it was pricey but I found it well worth it as I managed to get off all drugs completely.

I've now lent it to my daughter as my migraines became few and far between, however considering my now 3 day pounding migraine I wish I had it back!! However, I think her need is greater than mine at the moment.

Have a read about a Cefaly. Since I told (and showed it) to my GP she told me it had been mentioned at a seminar she'd been to and it was coming as highly recommended. She now recommends them to other patients.

Have you looked at whether any supplements might help? I take magnesium, I think it's about 350 or 400mg per day. It's the cheapest of the options recommended on the migraine action site, & I found it does actually improve my migraines a little bit. Be warned, there are different forms of magnesium- the cheapest is oxide, it gives most people terrible wind & even a bit of the runs at first. I've been on it for years & it settled down, but I think a lot of people switch to a more expensive type that doesn't cause the same unfortunate side effects!

I had similar problems with rizatriptan. The last time I took Sumatriptan (maybe 18 months ago) the heavy feeling was frightening.

I take a daily beta-blocker & it mostly works.

GP recently suggested trying either 1g of paracetamol, or whatever the standard dose for ibuprofen is, or 900mg aspirin as soon as the headache starts, & then sticking with that drug as per instructions on the packet. This is the latest NICE guidance.

As I'd not tried aspirin for years, I gave it a go. It didn't really work, but I might give it another go.

Might be worth considering- provided you are OK to take any of those 3 drugs. Might be best to check with pharmacist or GP first, of course.

Have you tried all of the non drug options- diet, e.g. eliminating the amino acid tyramine from your diet, or a daith piercing? Both of those have helped control mine where propranolol and triptans failed.

@BingIsAMassiveTwat

Have you tried all of the non drug options- diet, e.g. eliminating the amino acid tyramine from your diet, or a daith piercing? Both of those have helped control mine where propranolol and triptans failed.

Definitely this. There are quite a few things I don’t eat because they’re either immediate or cumulative triggers.

Just to let you know that my neurologist put me on a medical (not Pinterest version) Keto diet for mine and it really worked. (Or I wouldn’t have stuck to it, that’s for sure, because it’s pretty boring!) I’ve been doing it for four years now, and I thought that since I’m now on the other side of menopause I’d see what it’s like if I fall off the wagon and eat some “real food” with sugar in it. (I’m still taking meds, btw) Migraines came rolling in within the hour. Bloody diet works in my case! I get that it may not for everyone - my neurologist said that you generally know within about six weeks, but I noticed within about a month.

I take topiramate too. It's been amazing. No side effects for me. Before it I was having weekly migraines.

DH went through many trials to find a suitable regime. The triptans made him incapable of functioning normally. He takes ergotamine tartrate.

I’ve been on rizatriptan and sumatriptan for years- sumatriptan is great mostly, but does give me the sweats and leaves me feeling gross, unable to do much. But that’s better than migraine.
Rizatriptan I take with an aura, with a large strong coffee. It’s about the only time I drink coffee. Having spoken with dr today about migraines funny enough, they said the caffeine is known to help.
Problem I have, is sometimes, NOTHING works. I literally have no way of managing. So dr is referring to neurologist I think, but meanwhile the amitriptyline dose I’m on already is being increased. Dr asked how I manage the side effects of amitriptyline but I’ve been on it for years and don’t notice any now.

Are yours around your monthlies at all? Because that can be a case for a version of the pill to be started (has been mentioned to me in the past) and so could help.

I really hope you get some help, migraines are like nothing on earth.

Sometimes I can take Rizatriptan and it works fine, no major side effects, migraine goes away.

Other times I take it and it leaves me feeling weird all day. It usually does get rid of the migraine but some days all I can do is just sit and stare into space after it kicks in.

I'd say keep trying the Rizatriptan to see if this is a one off.

Also there are different doses. I think I was on 100mg Sumatriptan doses, then I asked the doc to switch me to 50mg and they fixed the migraines without such bad side effects, but I prefer Rizatriptan.

I think Rizatriptan comes in 5mg or 10mg doses, so if you're on the higher dose perhaps you could try the lower one?

I take Zolmitriptan. I still have to lay down for a period of time, and feel washed out after, but no nasty side effects. I've found them to b a life saver, as I can have several migraines a week, and without this the after effects lasted for days.

Thank you for all the responses and suggestions - I'm reading them with interest and taking mental notes for my next GP conversation as well as for my own use! It's incredible really, how many of us suffer.

Years ago they were much, much worse - 4 or 5 a week, absolutely floored me, could only sleep for 6-12 hours each time and pray that it lifted. Originally diagnosed as chronic tension headache syndrome, they were typically triggered by exercise or stress. I didn't really get a migraine diagnosis until 10 years ago, and even then no-one suggested a rescue treatment - only preventatives, which eventually took them right down to once a month at most.

They've increased again recently, which I think is hormone related as I'm just heading into menopause. But the triggers are still exercise, tension and anxiety, and certain types of chocolate (Marks and Spencers is lethal).

I've never been referred to a neurologist, I the GP would find the whole idea laughable. To quote one from about 8 years ago, "As you've had chronic headaches for 12 years and you're still here, I think we can rule out anything sinister."

Still didn't offer me a rescue treatment though.

Botox?

Don't know if this is good advice or not, but it works for me. I have the same side effects as you when I take a whole sumatriptan but if I only take half a tablet, I get the benefit of the drug but without the numbness etc.

Hormone-related migraines, in my experience, are resistant to drugs whereas those caused by food (in my case, caffeine, banana etc which I now avoid consuming) are tackled by sumatriptan.

That's interesting - occasionally the triptans don't seem to do much, other days they clear it in an hour.

Sundays one was cleared quickly with Rizatriptan although I felt like a dead-limbed zombie for several hours afterwards, yesterday I threw everything at it including painkillers, sumatriptan and sleep but it wouldn't budge. I went into a 2pm call feeling dreadful having had pain for 8 hours - and by the end of the call, it had miraculously vanished.

So weird, I remember a terrible one where I told my DH rather dramatically I wanted to die because I couldn't escape it - he had to come and collect me from a work function as I couldn't drive. I'd been down in the hotel room for hours. He gave me an ipod and earphones (remember those eh), which helped with nausea, for the drive home - and as I got out of the car an hour later, I realised it had gone.

How does that even happen!?

I've tried many drugs but always get the side effects of triptans.
The worst for me are nasal triptan and injectable sumatriptan.
After injecting I need a full day recovery just from the dreams. It takes me a day to sort reality out.

I am prescribed Zolmitriptan for chronic migraine. It's been a life saver. I don't get any nasty side effects that I am aware of, but I have FND so have constant pain sensations, but they haven't increased since taking it. The only wiped out feeling that I get are from the start of the migraine itself, not the tablet.