Migraine, what do you take, what can GP offer me?

[drspouse]

My migraines seem to be getting more frequent, I have recently come off hormonal contraception which I thought might have helped, but then wondered if it was making things worse, but now I'm off it I'm thinking it may have been helping!

I had 4 migraines between Jan 2nd and April 1st and then have had possibly 2 or even 3 since then. I'm not always sure that a headache IS a migraine but my rule of thumb is to take ibuprofen (preferably, or paracetamol if I don't have any) as soon as I can and then if it's not improved within half an hour to take the triptans (I have a melt in the mouth type tablet which is better than my previous one). Then to take another two of them another half an hour later, followed by codeine if still very painful and/or another pair of triptans two hours later if the other symptoms are still there. I also find a quick intake of sugar helps.

I generally get headache (clearly vascular, throbbing), sometimes nausea, sometimes tingly face/fingers, photophobia, sometimes shimmery patches in my vision. They can last for 2 hours or 2 days, usually shorter thankfully and usually they stop after going to sleep. Sometimes I don't feel up to driving but sometimes I kind of have to especially if I'm at work (nursery is near work) and need to get DS home. I'd rather drive after having my tablets than when feeling really rough though. I have considered asking a colleague who uses the same nursery and doesn't live far from me to give us a lift as obviously I have DS's car seat, but the colleague has two DC in the nursery so no room for us really.

Once a month is just about bearable though I'd rather not have them. Once every week or two is NOT.

I don't have any particular food triggers except maybe some kinds of red wine - thankfully I have enough information to know that chocolate isn't a trigger - it mainly seems to be stress, coming down from stress, tiredness, illness.

So, any thoughts/ideas/anything else your GP has suggested? I'm seeing the GP next week so might be good to go pre-armed.

I had a spell of increased migraine over Christmas/New Year. They were awful & I was bedridden for days at a time. I have had spells like this before though not as severe.

My GP put me on Propranolol for 4 months & touch wood, I've not had one attack during that time, nor after (so far!). I have been off them 2 weeks.

I was also recommended peppermint oil to smell & rub on my temples. Surprisingly this actually helped a lot so maybe worth a shot. I got mine in Holland & Barrett.

I also have a freeze pack that I find helps- I apply it to my neck first & then my temples in turn. I think the resulting constriction in the blood vessels makes a difference and this often allows me to sleep it off with the help of sumatriptan.

I would also say, if you think you have a migraine coming, don't waste precious time in treating it with ibuprofen if it rarely does the trick, go straight for the triptans & tackle it before it really takes hold.

I hope the GP can offer you something that will help.

It would depend what type of migraines you have, I think. My doctor referred told me that triptans could be bad for my particular type of migraine, I take Topiramate as a preventative, which does reduce the severity & frequency. I use paracetamol, ibuprofen, freeze pack, forehead strips or 4head stick as available/appropriate to the situation.

I had Imigran! No longer sure of the spelling as I have not had a migraine for several years now. When I did, they could last for 2 days and driving a car was totally out of the question, as was going to work. My days were spent in bed curled up in a ball. These tablets were much stronger than the over the counter ones that subsequently became available. I took one at the first sign of the migraine and then another about 1 hour later if the symptoms persisted. These tablets were a life saver for me and they always worked. They may not work for everyone. I think they were new on the market in the early 90s because my GP had not offered them to me before. I had just had the usual advice about trying to find out what triggered the headaches.

I'm on 80mg propranalol daily & then rizatriptan just in case but only needed it once in the past 4 months. Since being on propranalol, I can actually drink wine without being out of action for 2 days after with migraine. Changed my life!!!

i never have headaches , just neurogical symptoms- i take migralieve (pink)

My migraines and frequent "normal" headaches got worse as I got older (started in teens). The neurological symptoms got worse too. In the end they were pretty much daily and it was rare to have a day with no migraine or headache. I have various medications none very effective for long.

For the past 3 years I've been migraine free and almost completely headache free, and take no medication.

I have COMPLETELY and radically changed my diet (for weight loss and other health reasons) to grain free and restricted dairy (paleo/primal).

I wasn't expecting it to cure such a diverse range of health issues, but it did.

Do you think it might be worth trying an exclusion diet for a few weeks (something like whole30 if you want to google it)?

It might be especially worth considering if you have other issues going on such as ibs, skin rashes, allergies... They can all be connected. Is there any history of coeliac or other conditions related to gut damage? Because it might be worth considering that your increasing migraine are a symptom of one of these conditions.

I take Imigran, the injectable one. I tried the snout sprays, not so effective, and tablets, liable to vomit them. Have been on it for well over ten years now, so was interested to hear of a tongue-dissolving tablet. What is it?

The injections are not so convenient to carry around and are affected by heat so can't be kept in the car.

These are the wafers I used and they work well as long as I take them really quickly. They melt quickly so are really good if you get the nausea.

only have migraines rarely but I liked the magic injection (probably a triptan?), last time they just gave me naproxen which was still helpful

am also on lithium which am sure someone somewhere once said can be used to prevent some sorts of migraine but is not the nicest drug to take really

Thanks all, I'd forgotten I started this!
I don't have any gut type symptoms and I'm also likely to be spending a month or two away from home so an elimination diet isn't really on the cards just now.
The GP has given me a half dose of proponalol, which has been OK as far as it goes (just a week).
I think I suffer from not always knowing if it's a migraine or a normal headache, but I could definitely try both the triptans and the ibuprofen at the onset. I'd need to get my prescription upped, as I don't get that many at a time.
I'll try the cool pack tip too, thanks.

Everyone will be different but my GP says take 3 soluble aspirin as quick as you can. I have the melts mentioned above and also I find nurofen plus work quite well for me. They have codeine in them.

Generally, I can't stop a migraine but the meds relieve it so it isn't as strong. Still need to be st home or get home if I am out for a rest in a quiet room.

OP - I have the same as you. These are mostly hormonal as they sound in your case. Just before period when the hormones dip - it is sure to set in. But other things also trigger it like stress, noise, light, lack of sleep etc. Horrible. I try not taking medicines - but it depends on the circumstances of the day. People who I know swear by preventive medicines rather than pain killers. Low dose migralieve I believe works well. Apparently prevention is better than cure for those with chronic migraine - esp the hormonal kind - as there is no other prevention. Am currently pregnant (and due to hormonal levels being good - no migraines!) - but am thinking of going on preventive medicine after the delivery as my migraines are beginning to have a limiting effect on my family & professional life. Do tell us what you decide.