Migraines and triptans

[Sunart]

I've suffered with migraines since my teens but I would only get maybe two a year. For the last year I've started getting two a month and they last longer (up to 3 days). I guess it's hormonal as I'm 44 now and I didn't get a single one when pregnany or breastfeeding. They follow the same pattern. I lose part of my sight and get a horrible zig zag shimmering circle across my vision. This lasts about 30 mins then nothing until headache and nausea starts after another half hour. The doctor has prescribed me 40mg eletriptan. This works at stopping the pounding head from starting so that's great but I still get the nausea and pain in my head if I lean forward. I don't actually vomit but it is a horrible feeling the same as travel sickness and can last a few days. Should I be taking a second tablet or not bother if it didn't take away the nausea in the first place? Is there a different drug I should ask for? I have had an mri and waiting for the results to rule out anything other than migraines. I see my GP tomorrow so wanted to have an idea what I could ask for. Thank you .

I take sumatriptan and it's recommended to take a second dose if required. That sounds terrible. I go through pases on and off with them. When I get them I have to take the sumatriptan as well as a strong dose of codeine to really touch it

Another thing- diazepam works really well. Better than codeine actually.

This sounds so similar to my migraines. I also take sumatriptan when I have one, but what has really helped is taking amitryptaline daily. While I still get migraines, they are far less intense and the sumatriptan now pretty much stops all of the symptoms. (Prior to this, I’d also tried beta blockers, but they didn’t really help).

You can get anti nausea and anti dizziness tablets to take alongside your triptan.

Over the counter you can buy Buccastem so long as you specify it is for migraines. This is a tiny tablet that slips between you gum and upper lip and slowly dissolves into your bloodstream so fast action and you don't have to swallow when you feel sick!

If those aren't enough, there are a few anti nausea tablets that can be prescribed alongside a triptan. Ask me how I know... 😉

Good luck

I think if I were you I would try another triptan to see if there’s one that can help with the sickness, or perhaps you can try an anti sickness medication as well. I also suffered for years with hormonal migraines and when I started having them, there wasn’t many medications that worked, so I was lucky a new GP recommended triptans which really were great.

Ask for anti sickness medication. I found out years ago that getting the nausea under control massively reduced the severity and length of the migraine attacks.

You can buy it in the pharmacy as well if you need to - several options but there's one called Buccastem which you put behind your lip and it is absorbed into the blood stream which is good. Doesn't taste of much either.

You could try a different triptan to see if that helps. Or ask your GP for anti nausea meds. I'm prescribed metoclopramide alongside frovatriptan, as well as being on amitriptyline for prevention.

Im on propanalol slow release 80mg daily and that has dramatically helped migraines.

I am prescribed Rizatriptan for the pain, and ondansetron (zofran) for the nausea and vomiting. Sometimes a second dose of the Rizatriptan is necessary. The ondansetron is a lifesaver - it also comes as a dissolving wafer which absorbs mucosally. As an absolute last resort I am prescribed 10mg largactil which is actually an antipsychotic but is prescribed off label for migraines and is what they give as an IV infusion (at a higher dose) if you’re unlucky enough to have to be admitted to hospital for a non relenting migraine (which I have only a few times). The largactil will usually work, but it can have quite debilitating side effects of drowsiness and confusion so you can’t drive or anything after taking it. But it is very good for the relief if nothing else has worked - my Dr is happy for me to have it on hand (I work in the clinical field so my dr is happy that I know what I’m doing re meds and wouldn’t for example take too much). Your dr may be happy to prescribe it prn as a last resort. (Disclaimer, I’m in Australia so I’m not sure if some of the drugs may have different brand names in the UK. Largactil’s active ingredient is Chlorpromazine Hydrochloride if that helps).

I really sympathise with migraine sufferers, they really can be debilitating. 💐

Oh, as a non medication related tip - caffeine can actually help with migraines. Weird, but true. Mine are also often hormonal and come cyclically.

i found the triptan to be excellent for the pain but if I take it on an empty stomach it also causes the nausea. So might be that - I tend to try to eat a small something before I take it to reduce this as much as possible

I did read that nausea can be a side effect of eletriptan but then I also get the nausea if I don't take it but also then have the awful headache. The nausea leaves me feeling like I'm on a boat , not actually sick but just a constant bleugh feeling . I don't know if it would be considered bad enough to take an anti nausea med for if I'm not vomiting .

Migraines are so hard to explain to people who don't get them. I'm losing several days a month to this feeling of bleugh and it is getting me down. Does anyone else think that peri has made them worse/longer/ more frequent? Does hrt help with them? Although I had to take oestrogen for a round of ivf and that gave me terrible headaches .

It’s a bit trial-and-error with medications, but I’d say you need a preventative and an anti-nausea pill as well as the triptan. I’m on:

160mg slow release propanalol daily as a preventative

Rizatriptan at onset of migraine

Bucastem for nausea and vomiting (otherwise I bring the triptan up)

I’m perimenopausal too and have gone on HRT. At first they made my migraines worse but the GP urged me to persevere and she was right.

I feel for you. Migraines are so miserable as well as disruptive and painful. I hope you find medications that offer more relief.

I have just started taking the propranolol as a preventative and I think it is working - my migraines have reduced.

that said my neurologist warned me that sumatriptan might also have been causing some of them so after I started the preventative I decided to not take them immediately on getting symptoms to see. This was scary as they only work for me if I take them early on before the migraine takes hold. Bit quite a few times the migraine didn’t actually take hold. Don’t know if this is because I am taking fewer sumatriptans or the preventative. Either way I am happy as my life has been ruled by migraines. They are firmly linked to hormones and I am actually looking forward to coming out the other side of menopause as apparently they might recede then naturally