Migraines, and how to enjoy them (Not!)

August 21, 2006 7:32 AM

Migraineurs: Gather round the fire, and give a shout-out to your favorite treatments (and not-so-favorite triggers)

Migraines have been covered in several older threads, but with new advancements in meds (and new MeFi members), let's sound off your favorite treatments and triggers.

I'm pretty much a two-fioricet guy, myself. But for those code-orange and code red migraines, I treat myself to "The Cocktail."

-Two 50 mg fioricets (a barbiturate derivative with caffiene)
-Two bong hits (for the nausea)
-Two Immitrix
-100 mgs of Niacin (vitamin B) (causes facial flushing, and seems to relax the capillaries)
-A sweet, high carb, chocolaty dessert (when the nausea's down)

Combine ingredients in a blender, and mix for two minutes on highest setting.

Okay, I was bullshitting about the blender part. But this combination seems to work. Even so, I'm always on the lookout for new remedies. My migraines are triggered by sunlight and hard, outdoor exercise, mostly, but 50% of the time, they arrive out of the blue with none of these triggers. So I've been thinking of taking the plunge, and outfitting myself with SSRIs as a preventative ("prophylactic") measure. People on Mefi and elsewhere have recommended small amounts of Paxil . . . anybody in the know on this?

I now open the floor to comments . . .

posted by Gordion Knott to health & fitness (38 comments total)

My migraine treatment plans, in order of efficacy, consist of:

A) 2 excedrin slammed with a cocola

or

B) 1 - 2 shots and/or nasal sprays of Imitrex

or

C) 1 small bottle of Sunny D
C) 1 small bag of pork rinds


A & B actually work. C just makes me feel better after I've been sick with a migraine for 12 hours. I imagine the combo would give most people a migraine, though.
posted by headspace at 7:38 AM on August 21, 2006

Oh, and my triggers? Insomnia, bright, flashing lights, booming music, alcohol, heat, extreme motion.
posted by headspace at 7:39 AM on August 21, 2006

My solution is anticipating the triggers and just enduring it. It helps to concentrate on the moments just prior to the trigger and how your mind/head felt just afterward. Ask yourself if you were using the 3D-rotation part of your brain just prior and were jarred out of it? Perhaps your language center was interrupted from concentration? Restarting calculation in that aspect of thinking often makes mine go away really fast.

When I play Half Life 2 on my huge screen (projector) every time one of the load screens come up I get this splitting headache because my 3D-layout imagination section of brain got jarred out of whack when the 2D load screen came up and I was smacked back into reality. I figure out that if a load screen came up I could still have the map layout in mind, and slowly step into reality, and the headaches went almost completely away.

I say endure the pain and pay more attention to what your body is saying, than trying to muffle it with meds.
posted by vanoakenfold at 7:56 AM on August 21, 2006

Endure a migraine? Why suffer if you don't have to?

Triggers: Lack of sleep, peanut butter over several days, and a flare up of my Trigeminal Neuralgia. Also, driving at night for more than 20 to 25 minutes will give me a raging headache with nausea and light sensitivity.

Treatment: Sleep, Firoicet, and leaving work an hour early in the winter or car pooling with my husband so I'm not the driver.
posted by onhazier at 8:06 AM on August 21, 2006

It may be too late for you heavily medicated folks (seriously, how do you drive to the market?), but what I do is suffer through minor headaches and only take half doses (Advil, Tylenol, whatever's handy, really) for pretty bad ones. When a really bad headache hits, I take a regular dose--occasionally a double dose--of Maximum Strength Excedrin or some other multi-adjective pill. Works like a charm.
posted by Terminal Verbosity at 8:11 AM on August 21, 2006

Wow Gordion, sounds like you get KILLER headaches. I used to get very bad migraines in high school, but started going to the chiropractor my senior year and by the time I left for college they were under control. I mean, I used to get them 4-5 times a WEEK, and then I got them 1-2 times a month.

I get them very rarely now, though I still get bad headaches.

I avoid red wine like the plague--it's the only trigger I've found that's actually a trigger for me.

When I get a migraine I take lots of excedrin for the caffine, have a bunch of caffinated sody pop, stay off the computer, avoid tv, and just kind of chill. Eventually they go away.
posted by misanthropicsarah at 8:12 AM on August 21, 2006

I say endure the pain and pay more attention to what your body is saying, than trying to muffle it with meds.

I almost never get migranes any more, but the advice you give was inconceivable when I did. Using "calculation in that aspect of thinking" was entirely out of the question. I'm about as stoic a guy as you could hope to meet, and I found the pain utterly paralyzed all higher-order thought.

What worked best for me was to simulate sensory deprivation. Complete blackness and absolute quiet and time were all that worked for me. The drugs they had twenty years ago sucked.

Mine seemed to be triggered by either light or cold, although sometimes there was no discernable trigger. I did have a visual aura as a ten or fifteen minute warning sign, so I could try to get ready for them. I'm really glad they stopped.
posted by Lame_username at 8:16 AM on August 21, 2006

I say endure the pain and pay more attention to what your body is saying, than trying to muffle it with meds.

I can't even imagine. My migraines, if they get loose and past a point of treatment, can include auditory and visual hallucinations to the point that in the past that my husband has duct-taped socks to my hands to keep me from scratching myself bloody and tucking me into bed so tight it's like binding to keep me from beating my head on the wall. (For those of you talking about headaches, and not migraines, beating your head against the wall seems like it would make sense at the time; if you could just break it open and get the pressure and pain *out*...) Then there's the disorentation, the vomiting in reaction to the slightest bit of light or scent- it is, quite simply, a twelve-hour descent into hell.

seriously, how do you drive to the market?

You don't. Period.
posted by headspace at 8:23 AM on August 21, 2006

It may be too late for you heavily medicated folks (seriously, how do you drive to the market?)

Well, during a full blown migraine, driving to the store is not possible anyway. So the choice comes down to 8-12 hours of nonfunctioning accompanied by the feeling one's head is clamped in a vise while being stabbed in the eye with a ice pick or 8-12 hours of low-functioning accompanied by some mild spaciness and no pain. Guess which one I prefer.

My trigger is flashing lights. I get a 10-15 minute aura warning, which usually gives me enough time to find and down an Imitrex. One Imitrex doesn't completely wipe out my migraine but as taking two spikes my normally low blood pressure, I stick with a partial solution, call the day a loss and try to sleep it off.
posted by jamaro at 8:31 AM on August 21, 2006

I get eye pains and blue thunder (blue visual hallucination) when I have a migraine. I also get periodic loss of the ability to walk. It's very painful. I try hard, if I feel one coming on to medicate and stay lying down, because I don't want to go anywhere and keel over.
posted by parmanparman at 8:32 AM on August 21, 2006

No trigger that I've been able to identify. I have "cluster" migraine headaches. Every two or three years, I'll have one almost every day for 4 to 5 weeks. Usually wake up about 4 AM with them.

I've tried most meds: Imitrix, Floricet, Cafergot, Maxalt. Usually when I took them I would lie in the dark and quiet for an hour or two and they'd go away.

The last go-round, I didn't have any prescription meds and didn't go to the doctor. So I took a few Excedrin, layed down in the dark and quiet for an hour or two and they'd go away. I don't know if any of that stuff, including the Excedrin, actually did anything.
posted by marxchivist at 8:45 AM on August 21, 2006

My roommate goes in for acupuncture when she feels one coming on. I know this is second-hand info, and I've experienced first hand how it's turned her into a fully functioning human being on days where she would normally...not be. She just talks to her acupuncturist about what's going on, and he's been absolutely amazing at more or less fixing it for her right then and there.
posted by redsparkler at 8:47 AM on August 21, 2006

I don't get any aura at all. I generally wake up with one already going, and I don't recall ever having one start in the middle of the day. My triggers are poor sleep and those pesky monthly hormonal changes. I usually get pretty severe nausea but not the heavy-duty light and sound sensitivity.

I take 40mg of Relpax and it works well for me, but I only get 1 headache a month at most. I usually have to eat something for it to kick in, though, which sucks with the nausea. I can feel it working and I hate that sensation, so sometimes I call in sick to work even if the pain's gone because I still can't concentrate with that weird head-fuzzy feeling I get.
posted by cabingirl at 8:50 AM on August 21, 2006

I don't get them anymore--I have no idea what has changed in me, they just stopped. However, I figured out a non-narcotic way that worked about 75% of the time.

As soon as you feel one coming on (I could tell from numbness in fingers & tunnel vision; when they happened, I had about 20 minutes before the pain hit), lock yourself in the bathroom with the lights off. Either draw yourself a barely lukewarm--body temp--bath, or sit down with the shower running at that temperature.

I have no idea whatsoever why or how it works, but it did for me.
posted by dirtynumbangelboy at 8:51 AM on August 21, 2006

I took Depakote for six months as a prophalactic, and once that started giving me side effects, I weaned off that and went on Paxil. Paxil worked well to end my cluster migraines. When I went off the Paxil, voluntarily, I had terrible electric-shock style pulses all over my body. They lasted for a few months. I now get a migraine about once every three months, and I no longer have the extreme pain and aphasia that I once experienced. I think it was the Paxil that kind of kick-started my brain.
posted by MeetMegan at 8:54 AM on August 21, 2006

Had a flurry of five or six migraines last year and into February or March of this year. We never identified the trigger—wasn't caffeine, and I drink decaf anyway, and only occasionally, and eat a pretty regular diet. Seemed to be either stress and/or random luck of the draw, possibly hormonal (adolescence).

My migraines were pretty mild, so two 200mg Advil and sleeping for a few hours seemed to do the trick. Because I had a very obvious and unchanging aura—blind spots in the eye opposite the site of the pain which would usually increase until I was nearly blind on one side—there was never any doubt about when I should start medicating.
posted by cmyers at 8:59 AM on August 21, 2006

I do the acupuncture-as-prevention thing. I couldn't possibly do the 45 minute drive to his office while in the middle of a migraine, but one visit per 3 months seems to hold it for me. He also told me that egg yolks were off limits, and it seems to be true. (It explains why getting a flu shot gave me the worst migraine I have ever, ever had.)

Now if I get one I'm pretty much screwed since I fell through an insurance crack and I'm without coverage at the moment. I was an Amidrine person, which pretty much just knocked me out and I'd sleep it off. Now I do an aspirin/caffeine/benadryl combo (the benadryl is to knock me out) and try to sleep it off. Strangely, piano music seems to help. Only piano.
posted by cobaltnine at 9:01 AM on August 21, 2006

i spent six months trying to identify my triggers, and all we came up with was that i should drink coffee daily. the only other suggestion was lowl level stress on a subconcious level. that's not really helpfull though. i get weird floater auras and extreme light sensitivity, and then the headache, the eyes wanting to pop, and the nausea. i know my partner was a good man when he sat through a migraine with me a a truly dank berkeley co-op, even helping me to the toilet where i puked.

when i feel one coming i start first with drinking another cup of coffee, then an excedrin, then i try to take some b12, and if worse comes to worse, 40mg of relpax. usually, with coffee and exedrin and i can chop it down so i'm a mild zombie at work.
posted by kendrak at 9:04 AM on August 21, 2006

I got pretty bad ones as a kid. Thank the powers that be that I have (as far as I can tell) outgrown them. My trigger was sugar within 3 hours of waking up. Weird, I know, but if I ate anything with sugar in it in those three hours, BAM!

On a side note, the only quick breakfast one can find for a teenager (read: cereal) that has no sugar, is grape nuts. I HATE grape nuts!

I would get flashes so bad that I was, essentially, blind for an hour or two and waves of nausea. I would try to medicate (I was prescribed a heavy dose of Midrin and something else I can’t remember the name of) as soon as possible and get home to sleep for the next 16 hours, only waking up to take my pills every hour or two. The few times that I had to go through one "dry" I had to be restrained.

I always roll my eyes at folks who say things like, “Man today sucked. I had a migraine at work today so I had to take some Tylenol.” Yeah, if you don’t have claw marks on your face or haven’t been dry-heaving and crying for the past several hours till you pass out from the pain, you haven’t had a migraine. =)
posted by Chickenjack at 9:12 AM on August 21, 2006

Terminal Verbosity, migraine != headache. I had a friend suffer from chronic migraines. She could hardly stand, much less consider driving anywhere during the spells.

Don't know what in particular helped her cope, but the hours upon hours of unrelenting agony she had to endure made me very tolerant of my own slight headaches.
posted by slimepuppy at 9:19 AM on August 21, 2006

Ice pack + sleep.
posted by radioamy at 9:22 AM on August 21, 2006

I had up to three migraines a week for twenty years - and a headache of some description almost every day - until November 2004, when I started Topamax. Since then I've had four migraines. Total.

YMMV...
posted by dmd at 9:44 AM on August 21, 2006

I get a cluster of classic migraines about every 18 months to 2 years, usually about 3/4 of them happen within about 6 weeks of each other.

As soon as I see the first visual disturbance I neck down one Sumitriptan 50mg tablet (brand name - Imigran). If I rest for about 30 minutes I'm good to go and the migraine doesn't develop further. A couple of cups of strong black coffee help. I might feel a bit wishy washy for a couple of days but it's way better than when the only drug I could rely on was ergotamine tartrate/caffiene which had a string of side effects. With Sumitriptan I'm can stay functional, before Sumitriptan it was a two day lie down, vomiting, left side numbness, word blindness and the mother of all headaches.

In the old days, I discovered that blue light relieved the distress and pain somewhat when codiene/paracetamol/ dihydrocodiene didn't touch it.

My triggers, are stress, too little food, too much sleep and too little exercise (which happens when I have to attend courses that require me to sit on my arse all day)
posted by Arqa at 9:47 AM on August 21, 2006

Under my previous name, I asked about the value of seeing a neurologist, and want to reiterate again how glad I am that I did because (knock wood) I haven't had a bad migraine in more than a year.

I take Atenolol daily as a preventative. At the first "uh-oh" feeling (which I have learned to never ignore, because they always turn into migraines), I take an Anaprox (prescription-strength Aleve - basically the equivalent of 4 OTC). If that doesn't work in 15-30 minutes, I take a Relpax and another Anaprox.

I haven't missed a day of work because of a migraine since last May - used to go home at least 2x a month and used to take 12 Zomig or Imitrex a month.

I looooove my neurologist. (She said it is unusual for patients to get so much better so quickly, but I was really determined to beat the crap out of these things.)
posted by Sweetie Darling at 9:49 AM on August 21, 2006

dear god, I complain about migraines but after I read some of the responses above I feel so lucky.

My trigger is wine and anything with sulphites. If I am smart, I will drink lots and lots of water after consuming wine (and we are talking about 2 - 3 glasses for a migraine-level imbibation, it doesn't take much for me). I will drink 2x to 3x in water, what I drank in wine, and that alleviates the migraine potential.

If the migraine still hits the next day, then Advil is currently my friend. I take 2 extra-strength, then follow with another 2 extra-strength within 20 minutes (yep, that's 2g of Advil). Then, I will take 2 extra-strength every 4 hours. There have been some 12 extra-strength days in my past.

The day after, my stomach complains, but at least my head is painfree.

I recently started to feel nausea with my migraines. That's not a good sign.

However, there is a period of three months (Jan-March) where I don't have migraines at all, or if I do, they are very minor. That's a welcome break!

I think my migraines will also be triggered by hormone levels in my body. We don't know which ones yet - I don't have the time or the patience to keep a diary and go through the lab tests (nor are my doctors too concerned, given my current state of pain)

I have gotten rid of a day-old migraine by going to the track and running.

I also have increased my migraine sickness exponentially by going to the gym and doing part of a weights workout - never again !!! I could hardly drive myself home.

So, what works for me: water water water (even though I don't wanna drink anything) caffeine, salty foods, high-fat foods (when the nausea isn't there)

And, most importantly of all - taking that first batch of Advil ASAP, and not wait for the migraine to 'perhaps go away'
posted by seawallrunner at 9:49 AM on August 21, 2006

Oh, she also said that no one should be taking Fiorinal/Fioricet anymore - that it had been banned in something like 20 countries.
posted by Sweetie Darling at 9:50 AM on August 21, 2006

...anyone else here have seasonal migraines? eg my trend of no-migraines really is jan-march. am I unusual re this?
posted by seawallrunner at 9:51 AM on August 21, 2006

i have no idea what triggers mine, but one dose of maxalt and a twenty minute nap seems to knock it right down.
posted by fillsthepews at 10:05 AM on August 21, 2006

Magnesium tablets. My husband takes one when he feels a migraine coming on and it stops it in its tracks. He hasn't had a full-blown attack since he discovered this remedy.
posted by macinchik at 10:19 AM on August 21, 2006

I used to have serious migraines at least weekly. Imitrex didn't work consistently against them, so I went on a small daily dose of elavil as a preventative, but very quickly I ended up hating that. I would wake up groggy and wouldn't get as excited and passionate about the things I cared about.

I know that the complexities of everyone's triggers vary, but in my case, quitting caffeine completely got rid of my headaches, and allowed me to stop the elavil. My head was really foggy for two weeks, relatively foggy for three more weeks, and then I was fine.

So in my case, although allergies and changing mealtimes and sleeping schedules were triggers, caffeine turned out to be a kind of umbrella trigger or master trigger. In the last three years, the only two migraines that I've gotten have been when I tried to phase a small amount of chocolate back into my diet (i.e. a chocolate chip cookie). I stopped that experiment. Inevitably, twenty-four hours after having any amount of caffeine, the withdrawal triggered a migraine that would take me a couple days to completely recover from.

Again, I know everyone's situation is different, but considering what's worked for me, it's interesting that caffeine is a treatment for some people, and an overarching trigger for others.

Also, the fact that allergies (pollen, mold, etc.) contribute to my headaches could point to a possible reason why seawallrunner's headaches are seasonal.
posted by umbú at 11:31 AM on August 21, 2006

I got my first migraine when I was 7, and honestly thought I was going to die. I get blue flashes about an hour before the headache hits. Occasionally, I also get numbness and tingling on one side of my body and have difficulty with saying the right words, when I know that I'm thinking them. It scares the crap out of me, but I've been checked out and they are considered hemiplegic migraines.
23 years later, I've tried pretty much everything. I've never been able to figure out my triggers. Sound doesn't bother me, but the slightest bit of light does. They seem to be cyclic - I'll get them at least 4-5 times a week from November - April, and then they taper off. Percocet, which we tried to get away from, worked really well during the last cycle, until I discovered that those times where I thought I was getting the beginning of a migraine was just a rebound headache.
After another frustrated visit to the doctor as we sat with his textbooks opened around us, he gave me a look and said "I know it sounds ridiculous, but have you tried Excedrin?" At that point, I'd try anything at all - and I'm floored that 3 years later, I swear by it - at least, it's worked for the handful of migraines I've had since. But for the hemiplegic ones, I take Reglan - not Relpax - which is amazing too when coupled with some ice.
Fioricet was one medication that worked well enough that I'd go back to - Sweetie Darling, did she give any more info about why it was banned?
And speaking of coupling - I can't believe nobody has mentioned sex as a treatment. Granted, it's not very sexy for your partner to be going at it with somebody who's crying and doesn't want to move their head, but it really does help. (As long as you aren't too nausated, I suppose.)
posted by Iamtherealme at 12:43 PM on August 21, 2006

onhazier: cheaper and less addictive, for one thing. Pain is an indicator of a problem -- it's not just there to cover up. Perhaps if you knew the problem first and couldn't solve it by non-med means, meds could be a last resort. Don't opt for the meds right away.
posted by vanoakenfold at 12:58 PM on August 21, 2006

Fioricet was one medication that worked well enough that I'd go back to - Sweetie Darling, did she give any more info about why it was banned?

The primary concern appears to be that they are quite addictive (Journal of Head and Face Pain). There is also concern about rebound headaches as you come off the Firoicet. An overview for the layperson can be found on about.com
posted by Lame_username at 1:54 PM on August 21, 2006

Triggers? Pff. No idea. There's a visual component and a diet component, but I'll be damned if I can suss it out. I try to eat well, sleep well, and be calm.

My migraines are pretty mild, especially compared with the neural shock and awe that some people have to make it through. They start visually for me, and I get about an hour or so before the blind spots and vision fractures get so bad it's hard to navigate--I had to bike home once without either peripheral or central vision. (It sucked.)

I usually end up eating a handful of Excedrin, dry heaving a bit, donning an eyemask and some ear plugs and zoning/passing out for a few hours. Then I get up and eat about twice as much as I normally do and generally act like a lobotomized bear, fresh from winter slumber. It takes about 24 hours from that point to reset to my normal, witty self. The pain isn't that bad (I've had worse regular headaches), but the visuals and nausea are the real mind-killers. Besides those two, the worst part is coming down from the migraine but still being ripped to the tits on a full half-gram of caffeine.

I tried getting stoned once, and it was interesting--I still had a migraine, but instead of retching and moaning I went and got a bunch of graham crackers, marshmallows, chocolate chips, and peanut butter and ended up watching cartoons while my head hurt in a really abstract way. Wasn't all that bad, but it took a lot longer to get back to normal.

Kendrak: Cloyne is not a good place to puke or be sick. You have my sympathies.
posted by Coda at 11:34 PM on August 21, 2006

Pain is an indicator of a problem -- it's not just there to cover up.

Not always. The human body is complicated and sometimes there is pain for no good reason.
The vast majority of us will experience at least several headaches a year, and fortunately, the overwhelming majority of headaches are benign, and are not indicative of any serious disease.

Even with severe pain...headache is generally not indicative of any serious underlying disorder.

Someone in a previous thread suggested Orudis KT (ketoprophen), which is over the counter; that's the only thing that will touch my headaches. Mine seem to be triggered by not getting enough sleep and then oversleeping. Once I have one, caffeine, sugary juice, exercise, sex, and hot showers (not necessarily in that order, or all at once!) help a bit but won't make the headache go away. Lately I've been taking a multivitamin/multimineral supplement with magnesium which seems to be preventing them so far.
posted by Violet Hour at 12:50 AM on August 22, 2006

Migraine sufferer throughout my teenage years, of the "shock and awe" type, 2-3 days a month of agony, non-functioning, no realy triggers except I would be guaranteed to have one after an Exam (release of stress thankfully).
At 21 yrs my pre-med boyfriend thought the amount of drugs I was taking was crazy and bought me a course of 6 accupuncture treatments.
I have had one migraine since (20years ago!) and a few headaches.
It amzaes me that some people call simple headaches migraines, they clearly don't know the difference.
posted by Wilder at 5:05 AM on August 22, 2006

Can I just take this opportunity to urge urge urge people to go see a neurologist who focuses on migraines? I've talked to so many people with migraine, especially those who get it relatively infrequently, who try to self-medicate with excedrin or something and fail. Go to the doctor. The doctor can help.

Now, I'm not a doctor, but I've done a lot of research on this, since it's pretty much the great bane of my life (though I'm lucky that my symptoms are not as severe as some folks here).

Personally, I've been getting them for 15 years, since I was about 10. None of the traditional painkillers (from ibuprofen and so on to narcotics) helped. Cafergot gave me some relief, but caused some bounceback and really left me a mess. Imitrex (sumatriptan) didn't work, but Maxalt (rizatriptan) works pretty well. With triptans, though, you can suffer from bounceback if you take them more than a couple times a month. In that case you should be trying to control your triggers and consider prophylactic medication.

I also tried accupuncture, which was innefective for me.

I've recently started taking coenzyme q10 and magnesium supplements, and may take feverfew as well. There's some evidence for all of those., but certainly ymmv. I haven't been taking them long enough to make a judgement even for myself, but I figured if I could buy them at costco, they were worth a shot :).

But seriously... see a doctor. And not just a family doctor, they tend to think they can help but they rarely have any understanding of migraine -- it's a fast-changing field, particularly the past 15 years or so.

I also found reading Heal Your Headache very useful, particularly in it's emphasis on prophylaxis.
posted by YoungAmerican at 9:20 AM on August 22, 2006

Late, but since YoungAmerican mentioned feverfew, I will say that taking that every evening before bed has cut down my migraines by about two thirds.

My triggers are my period and stress. Oddly, I can't be still. Sitting, lying down or standing just...the pain is unbearable. It is when I walk (generally bouncing off walls) too, but it is less unbearable.

If I can keep darvocet down, that will generally knock me out enough to sleep. If I can sleep, I'll wake up groggy, but without pain.
posted by QIbHom at 9:09 AM on August 23, 2006