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!

Not a medication but can I recommend Severe headache expert com. He is an nhs consultant neurologist who specialises in headache and migraine, don't be put off by the website name. He has a free email course to help you manage it better, simple ideas that are a starting point and worth a shot,

I do feel your pain with this, I have a rare form of migraine that have thrown all sorts at to no avail, I am regularly hospitalised with it.

Have you tried an NSAID? Like ibuprofen or Naproxen? There is a good evidence base for the use of NSAIDs. You can take 600mg ibuprofen (3x 200mg tablets) or I get Naproxen 500mg from the GP. Has really helped me as I find the side effects of Triptans too much.

I take cocodamol 30 /500mg for sciatica and back pain and if I get a migraine occur I take a couple more providing its at least an hour after my last dose and it helps. I remember having morphine for several months before my back operation and every time I saw the aura I got no headache at all! I have tried migraine medication in the past but it doesn't do anything that cocodamol does.

@fantasmasgoria1 I would advise against taking Co-codamol only an hour after a previous dose. You could easily take too much paracetamol doing this, you need to wait 4-6 hours.

I was going to suggest ibuprofen too - as long as I get in early it really helps stop them
in their tracks from a pain perspective. I still feel fuzzy and unable to think straight but my head doesn’t feel like it’s resting on concrete or like my eye socket is going to cave in!

I didn’t get on with sumatriptan but zolmitriptan has been a game changer. I can function as long as I take it early enough in an attack.

I don't find anything works once the migraine takes hold but can occasionally stop it if I catch it as soon as I get the first sign.

Sumatriptan didn't do much for me so my GP suggested 3 x Paracetamol and 3 x 300mg Aspirin and that sometimes works without side effects (obviously that's more than recommended dose but dr said that it's fine occasionally and as long as you are careful to leave long enough before taking anymore)

If you have the money, pay to see a neurologist who specialises in migraine.

Best £300 I ever spent (I went in London, out of London will be cheaper).

I now take Almotriptan as my reliever - not perfect but masses better than sumotriptan ever was.

And I couldn't have propranolol or amitriptylline and topiramate wasn't working - the specialist pushed it to the right dose for me.

The thing with migraine is there are masses and masses of options, you just need to see someone with the experience to get the right one for you.

The specialist also gave me loads of advice about triggers, how to take my meds, how to avoid taking too much, it was brilliant. I'd had none of this advice before.

My NHS referral resulted in a massive wait and a letter. I couldn't wait any longer. I paid £300 to a plumber when my heating broke and honestly, my health was far more important to me than my immersion heater.

BF has cluster headaches, so different, but similar medications. He has sumatriptan spray which wasn't working really, so has been given verapamil too which seems to be helping to lessen the frequency and intensity a bit. It's used for migrane too, so might be worth a shot? Sounds like anything would be tbh...

I take 2 x 500mg paracetamol and 3 x 300mg soluble aspirin as soon as possible after the pain starts and that usually stops it
I don't have anywhere near as severe a problem with migraines as you though op, you have my admiration (if that's the right wprd) for coping with so many for so long

I'm thinking of getting a consultation with the migraine centre as they are doing virtual appointments (they're in London and I'm up north). I'd got close to booking it but then I've had a really good stint without a migraine. I have cut down drastically on caffeine and alcohol lately though which has possibly helped.

I take zolmitriptan as and when needed. I can get bad ones but also a lot of annoying milder ones where I'll spend a few hours dithering about whether it's worth taking a tablet and then it gradually gets worse so I take one (but by then it's a bit late and doesn't always get rid)

2 dihydrocodeine and 2 paracetamol, then go to sleep. It's the only thing that works for me, triptains didn't work. I was put on amitriptyline when I was having 3-4 migraines a week and that slowed them right down. Then I recovered from depression and didn't have one in over 3 years.
A PP recommended Venlafaxine. I really wouldn't. I took that for depression and coming off it was a nightmare. Took me 6 months and I had hideous side effects. If anyone is considering taking an anti depressant for prevention - first look up the withdrawal and get some first hand accounts.

My new thing is taking 3 ibuprofen with the triptan (usually Rizatriptan) which seems to help offset the triptan side effects. Was my doc's recommendation. I've no idea why it works.

Acupuncture! Miracle cure after years of hell. Recommended by NICE too.

All the different ones I've tried (Naratriptan, Sumatriptan, eletriptan and others) Cause me to get the pain relief and leave me exhausted feeling like I've been long distance travelling, travel sick if you will.
I'm now taling candesartan as a daily preventive medication, it doesn't seem to be doing anything.
I was going to try the daith piercing next, but I'm hesitating.

A friend abroad takes Relpax....it is sold in Turkey under that name...says its amazing and no side effects !

The migraine trust lists headache clinics they are run by neurologists
www.migrainetrust.org/living-with-migraine/seeking-medical-advice/migraine-clinics/

Dd taking the new cgrp med with almotriptan for severe migraine days

www.nationalmigrainecentre.org.uk/nice-recommends-fremanezumab-ajovy-for-use-in-the-nhs/#:~:text=National%20Institute%20for%20Health%20and,least%208%20of%20those%20having

I have been taking Candesartan for about 2 years now and it works very well for me as a preventative. My migraines are hormonal. It has definitely reduced the duration, frequency and severity of them.

@earsup

A friend abroad takes Relpax....it is sold in Turkey under that name...says its amazing and no side effects !

Relpax is Eletriptan, that was my first medication, worked well for ages, then seemed to just stop being so effective.

For me, this works to take the edge off a migraine (although I am not claiming it cures a severe migraine):

"Tiger balm" (a sort of warming vaseline) applied to temples.
Full fat diet coke.
Paracetamol and ibuprofen.
These together normally take the edge off enough that I can lie in a dark room and sleep (otherwise it hurts too much!)
Often I find an hour or so of proper, deep sleep sort of resets me. So I'm not 100%, but not crippled by the migraine either.
I know that's probably annoying because you're after proper cures, but the above really genuinely helps me most of the time. Sometimes it even cures it completely after I've had the sleep!
Perhaps in combination with more drastic cures it could help.

The Tiger balm thing sounds like nonsense but it really helps. It is like a menthol/camphor thing and it irritates my skin, leaving a red mark on my temple but it is worth it. It heats up the skin, and i think possibly affects the blood vessel in the temple? That's the only explanation I can come up with for how it works.

At one point I had really crippling, frequent migraines so I know how awful it can be (I'm amazed I wasn't fired from my job at the time). Getting pregnant stopped them weirdly! And even after having the baby, they never returned at the same frequency (touch wood!) So must be a hormonal connection.

Like the PP, eletriptan worked best for me. It doesn't wipe you out completely like the other triptans. However it does leave me hazy for about half a day so I'm reluctant to take it if I have to be out and about.

Have you tried CBD oil? I just started recently so can't say anything for sure but it's effectively aborted several headaches and mild migraines. I take 20-30mg as soon as I feel the first twinge, and repeated it every few hours if needed. I bought a high dose oil (20%) so each drop contains 10mg, which is much easier to take under the tongue.

If stress/anxiety/tension tend to contribute to the migraines then CBD might work double action for those as well.

Are they migraines or could they be cluster headaches?
I get both. Cluster headaches are blindingly agonising headaches which feel like the equivalent of giving birth in headache form! I alternate between the two. I have had nerve blocks in the back if my head which didnt work for tjise, but whst works is 15 mins of high flow oxygen. I have a tank now at home on prescription. I take it with 2 paracetamol and it almost completely lifts the headaches, i might needit several times over a couple of days but its worth looking into. Its worth considering if there might be more than one type of headache involved.

As a result of this thread I spent yesterday evening reviewing migraine diagnosis, meds, etc.

I now think I get both migraines and trigeminal neuralgia (they're quite different, and I get either one or the other). The migraines aren't actually as bad as the neuralgia - they're treatable, and they don't actually hurt as much.

So now I'm looking for treatment/cures for trigeminal neuralgia.

Oh, but the trigeminal neuralgia is only in one ear, so perhaps it's something similar but not actually the same?