More on Migraines

March 4, 2005 5:21 PM

Another migraine question. I'm wondering if any chronic migraine sufferers have had success with preventative medications.

Many migraine suffers find drugs like Imitrex useful when taken at the first sign of an attack. Trouble is, Imitrex is not cheap, at least here in Canada where it costs $17 - $20 a pill. I'm told that preventative medications are much cheaper, but do they work? Propranolol was mentioned in this thread , has anyone else had positive experiences with this or any other preventative medications? Thanks in advance.

posted by btwillig to health & fitness (12 comments total)

There's a way to manipulate the syringes of injectible Imitrex to make it last longer than one dose. You might find more info if you google sites for cluster headache suffers.
posted by insideout at 6:11 PM on March 4, 2005

I wish I could answer your original question; instead I have two recommendations regarding acquiring Imitrex in an affordable manner (even if the preventative measures work most of the time, you HAVE to have something on hand for the times they don't...).

1. Mexico. I recently purchased 4- 50mg. Sumatriptan (generic Imitrex) pills over the counter (no prescription) for about $25USD.
2. Your local clinic. $10 will generally get you a doctor's visit; the doctor will very likely have samples they can give you. I got Relpax for a year at no cost-- very fortunate.

I wish you luck, and have felt your pain!
posted by mireille at 8:00 PM on March 4, 2005

I have heard about people having success with Topomax, though I haven't tried it myself. Neither Relpax nor Imitrex stopped migraines for me. I don't know what gender you are, but perhaps this would be helpful to other women reading this thread even if you aren't one, btwillig. I've been on Seasonale for about 7 months now, and my migraines (and regular headaches) have significantly decreased -- by about 85% I'd say.

At any rate, I'd suggest you look into Topomax. A handful of fairly close friends have had great results. Good luck!
posted by katie at 8:18 PM on March 4, 2005

Topamax isn't something you take when you feel a migraine coming on - it's definitely a maintenance drug. I take a dose in the morning and another in the evening and I haven't had a single headache (other than the normal day to day things or ones that I caused by drinking too much/staying out too late, etc).

Go get yourself some. You'll be much happier :-)
posted by glyphlet at 8:33 PM on March 4, 2005

I was on Sibelium for about 2 years it was a life saver. I had been given Ergot and Imitrex in the past but Ergot doesn't help and I'm severely allergic to Imitrex. Before I went on Sibelium I had a headache that had lasted for years without relief. After a week or so on the new drug and all headaches and migraines went away. The downside for me was after about a year or so I developed shakes, at times my hand would shake uncontrollably, my legs would also suffer spasms and I thought (though not 100% sure) my tongue started to move. These are all signs of tardive dyskinesia which can be a horrible side effect - usually seen in people who take anti-psychotic drugs at high doses for a long time. If you catch the symptoms early enough it is reversible. I may be a bit unique so don't let my experience scare you away, for the time I was on them it was well worth it, I was pain free the whole time. Only other side effect for me was drowsiness but I took it at night so helped me to fall asleep.
posted by squeak at 1:02 AM on March 5, 2005

I took amitryptiline for my migraines for a while, with great results - far better than Imitrex, Maxalt, etc. There were side effects: my appetite went up and I found it much harder to wake up in the morning.
posted by Phatty Lumpkin at 2:01 AM on March 5, 2005

Thanks to everyone who participated. I've had some success getting samples from my clinic, mireille. Unfortunately, my last couple visits I've left empty handed -- I guess they've been giving a lot out. I was surprised to read about a generic version, I'm not sure if I can get access here in Canada, but I'll look into it.

Glad to hear you've had success with Seasonale, Katie. Gender is a factor, but most migraine suffers are women so it was worth posting.

As for Topamax and Sibelium, I'll do some research and consult w/the doctor. A couple years ago I was on Amitrytiline and it didn't have much effect for me. It kind of put me off using preventative medication, but it's time I explored that option again.
posted by btwillig at 10:00 AM on March 5, 2005

Imitrex and the other *-triptans aren't preventatives, they're abortives. You're supposed to be feeling symptoms by the time you take them.

Propranolol, verapamil, nortriptyline (not so much amitriptyline), topiramate, lamotrigine, valproic acid are all preventative (or prophylactic) medications. You have to take them every day, some multiple times a day, whether you're having headaches or not. The idea is that being on them stops the headaches before they start by interrupting the causative mechanism. All these medicines have side effects, which vary from person to person in unpredictable ways.

The guidelines suggest that people who are losing productive time due to headaches, three times or more per month, should be on prophylactic therapy.

All the abortives cause rebound headache, including the triptans. I don't like my patients taking triptans more than twice a week.
posted by ikkyu2 at 9:41 PM on March 5, 2005

My advice is that whatever your doctor gives you, look it up first. My doctor put me on some weird 'preventative' medication that had me so out of sorts I wasn't the same person, it messed up my blood pressure to boot, and he'd described it as having minimal side effects. A PDR is your friend.
posted by nile_red at 9:12 AM on March 6, 2005

It's not prescription or even a drug, but I've had a lot of success taking a magnesium pill a day. I think it depends on the type of migraines you get, but as it's only a couple dollars for a large bottle at any CVS or Target, might be worth a try.
posted by JonahBlack at 8:17 PM on March 6, 2005

I know this is rather late, but I am prone to simple migraines. My physician at Northwestern University's headache clinic prescribed a non-traditional medication - Paxil (an antidepressant) for my headaches. It, apparently, is earning renoun as a headache preventative. I take it once daily, at 12.5 mg, a very small dose. I haven't had a single migraine since two weeks after starting on Paxil. I started taking it more than a year ago.

Beware, though, if you ever plan to discontinue use of Paxil, you must do so under supervision of a physician. I accidentally waited too long to fill a prescription and went through strange withdrawal symptoms, including "shock" like sensations all over my body. It can be very disturbing.
posted by MeetMegan at 8:58 AM on March 8, 2005

In addition to the *triptans (I go for Axert), I had fabulous success with feverfew, a traditional herbal migraine treatment. The drawback to many herbals in the US is they're not standardized -- I did find one vendor in Green Bay, Wisconsin.

Other feverfews I took gave me indigestion, but their 30mg of 6% parthenolide, one a day, has meant only one or no migraines per cycle.

Before that, I had classic migraines 15/days a month. I still have ocular migraine -- just the lightshow, no pain, but that's actually kinda fun, once I knew I wasn't going crazy.
posted by pricklefoot at 7:12 PM on March 8, 2005