Anti-migraine medicine: what's it like and does it help to prove anything?

[Solo2]

DS1 aged 9, is having hospital investigation for unexplained recurrent vomiting. The doctors don't know why he vomits a lot - about 18 episodes a year - and are starting a process of elimination to rule out various possible things.

One line of thinking is that he might have abdominal migraine, as his non-identical twin has migraine headaches (at least this is again what the hospital think - but I'm still unconvincedabout this myself).

So they want to put DS1 on anti-migraine medication for at least three months to see if it reduces vomiting. His twin has never been prescribed this though?!

I don't yet know what this will be and it's NOT migraleve but an older one that's been around for yrs and can cause tiredness - so you take it at night.

Does this sound like anything anyone else's child has been on? If so, are there any other side effects/ contra-indications? I'm not that happy with him taking a medicine that he may not even need.

Also, how can it prove anything whilst he's on it? If he STILL vomits, then that could be because he's one of the 50% who don't respond to it but may still have abdominal migraine. OR - it could be that he's having a normal tummy bug? If he doesn't vomit whilst on it, it COULD be that he HAS got abdominal migraine and is responding to the meds but it could ALSO be that he doesn't have it but hasn't vomited simply cos he's not been ill over this time.

Can anyone explain therefore why the doctor thinks it's a good idea to put him on it and should I just go along with her decision?

is it Migravess?

or Maxolon?

I used to have cyclic vomiting syndrome, which progressed to classical migraines, and the only thing that would ward an episode off was migraine meds. But as I always woke up in the night feeling v hot and odd as I went into one, I was able to take it then, rather than regularly.

TBH, I'd have done anything to stop the horror of the 24 hour vomit/passout/vomit cycles

Thanks. I don't know yet what the doctor had in mind only that it's a drug that's been around for ages (NOT migraleve she said), that 50% don't respond to it anyway, that it makes you feel tired and hungry.

I am not at all sure I want DS1 to take medication that treats a condition he may not have.

He doesn't have a classic migraine picture. He doesn't particularly get headaches or stomach aches. He simply vomits a lot, for a variety of reasons compared with most of his peers. He will vomit with any kind of tummy bug - but often several times acorss a 12 hrs period and for several days eg 9 days. He will vomit when he doesn't have a tummy bug but hasn't had a poo for 2 days. He may vomit if he smells, sees or tastes anything that would just make another child slightly disgusted.

He also has episodes (which are the only ones closest to a migraine-like episode) where for no apparent reason at all, he'll feel extremely sick, vomit and then lie down and be totally fine about 4 hrs or 1 day later. But there can be so many reasons why he vomits that I don't know - and nor does the doctor - whether it's a lot of different things or one underlying cause.

I really don't like the idea of giving a child - especially my own - some medication that he may not need. I've come from a family background myself (medical) where the most you'd ever take would be paracetemol and always felt that unless there's a v clear definable conditon meriting meds. then leave well alone.

I don't like the idea of side effects, of any knock-on effects if/when he comes off a drug etc etc.

I suppose I need to find out first what the medicine is. Would I be found negligent/ neglectful as a parent if I said that for the time being, I don't want him to have the meds. - if I discussed this with the GP? Would they claim I was depriving DS1 of necessary treatment?

Aren't prophylactic migraine meds quite powerful and can affect neurotransmitter systems etc etc and have contraindications when taken with any other drugs of specific types???

Bumping my own thread again as have been awake since 3am worrying about DS1 being put on meds he may not at all need.

Still got those two main questions:

a) for the older style anti-migraine drugs, what side effects are they and on what boilogical systems do they work - thus, what else might they affect?

b) is it OK for a parent to decide NOT to allow experimenting with meds on ones' DC if there is no absolute indication that he needs them - or would I be accused of negligence?

Anyone up and with any advice please?

can only ask your b part: I have in the past declined meds for my ds that I felt uncomfortable with, even at one point discharged him from hosp as I disagreed with what was being done (and created a massive row). However, in the end I was proved right, not that I went back to make a point, when we went for a 2nd oppinion it was all made obvious. I would say, trust your gut and ask about all options or even a referral.

There are loads of issued that are diet related and b/c they don't create an obv structural problem you may not even find the answer that way.

To me it seems your ds tummy is very sensitive, which may also be due to low liver or stomach enzymes; it's not w/o reason the body would react with vom, it's usually coz it's unable to handle certain things so rejects them.

Has he had liver enzymes test? Sometimes if they are borderline high or low, they still would cause problems. Or kidney function test? What's been his last meal when he voms (never mind the trigger itself)?

oh heck, I meant answer

Solo2, so glad I've seen your post, I hope I can help put your mind at rest. I'll keep it as simple as I can.

My DS is 10 and has cyclic vomiting syndrome.

He was diagnosed in 2007 after episodes of unexplained vomiting, every 3 weeks, lasting between 12-16 hours. No headache, no tummy ache, just unrelenting vomiting. He would recover extremely quickly once the episode ended.

The medication he was prescribed and still takes is Sanomigran. (Pizotifen) I'm sure this is what you are talking about as it causes an increase in appetite and can cause tiredness. I was told it was the only thing DS could safely take until he was 12.

I have to say that while it took months to get the dosage right, this medication works. They are not without side effects, but they have given my son his life back.

I know a fair bit about this medication now so if you find this is what he's being offered and want to talk about it in more detail I'll watch this thread and keep in touch.

Best of luck xx

Thanks Saralou. It does sound like it must be this one the doctor meant. The thing is, having googled the drug and seen how it acts, on the basic biological level - plus side effects - I feel even more reluctant that DS1 should juts be 'tried' on it for 3 months.

He deosn't - as far as I can see - present with the classic signs of cyclical vomiting symdrome nor with abdominal migraine. In fact, the doctore only suggested these conditions because she couldn't think of anything else it might be - although he's soon to be tested - blood tests and barium meal - for other possible things.

When I look back over two years that I've recorded the number of times he vomits - (about 18 episodes, each of which would include anything from one to 15 vomits per day of that episode) - it seems to me that there are a variety of reasons why he vomits and that he simply has a hyper-sensitive gag reflex.

So - if he gets any kind of virus - he tedns to vomit more than most children. If he hasn't pooed for a couple of days, he might - or might not - vomit once and be fine afterwards...if he sees, smells or tastes anything that disgusts him, he might vomit (although this is less frequent nowadays). If he has a tummy bug, he'll vomit a lot...

But I don't think this is like what i read of cyclical vomiting syndrom or abdominal migraine. I think the doctor is - as you'd expect - searching for why he vomits a lot and so her best try, along with various tests, is to put him on meds for antimigraine/ cyclical vomiting meds.

I can see her reasoning but I'm really averse to anyone - especially my DCs - taking something so powerful - that can have rebound effects when you come off it - when they might not need it.

Between times that DS1 is ill or - even if not ill - vomits - he is absolutely fine. I'd hate him to be on medication when he's OK. Whilst he vomits - on very rough average (and for a variety of reasons) every two months - if i look at this another way, this means that he can have 8 to 10 weeks when he doesn't vomit and is absolutely fine.

Yet because he vomits so much compared to most of his peers, this is why I've sought further help and investigations. So I feel a bit silly not to pursue what the doctor has suggested. However, coming from a medical family background, I know only too well that medicine is not an exact science and that every day, doctors have to make decisions based on a short NHS assessment, that guides them to a first-choice next step and then so on and so on in a process of elimination - if a diagnosis isn't immediately obvious.

Nightcat, when you decided against medical advice for your DC, were you treated less well after this/ frowned upon/ accused of not looking after your child?

hi Solo, been away so apols for delay

Not at all, didn't change drs, although GPs have changed a few times. You can be v diplomatic about it all too, just by asking for more time to think about the treatment (unless emergency of course) or asking about all the options.

Many consultants now work as part of a clinic, so sometimes you don't see the one you saw earlier and if you find one that is more open-minded, then you can beg at all costs to stay with him - (this is what we ended up doing, right down to explaining why).

I do agree with you that modern medicine is trying to turn art into science with not always good results.

If he was mine, I prob wouldn't medicate, would prob keep some kind of food diary to pinpoint a trigger or maybe go down the route of liver/kidney function tests.

Nutritionists are good at reading various symptopms/features too, so a good start I reckon.