Migraine

It's been a long struggle but I seem to have found the right mixture of medications (topamax and botox) to reduce my headaches to 2 weeks out of the month - the week before and the week of my cycle. It's exactly like clockwork and its very painful and very frustrating still. I have read on old topics about the use of amerge or frova to take for menstrual migraines and I think I've tried frova in the past and had little luck. I'm worried about using either because I'm very sensitive to medications and have suffered from Medication Overuse Headache due to triptans twice in the past. I typically take zomig or treximet to relieve my headaces but I cannot take it more than 9 times a month or two days in a row because I will get the MOI. Since Amerge is also a triptan, won't I have the same problem if I take it twice daily for two weeks? Has anyone else had this problem?

I suppose it's possible for the MOH from triptans to go either of two ways, scenario-wise. One one hand, if you're susceptible to triggering from any one triptan, then you might be a bit more susceptible to triggering from others. On the other hand, though, because each triptan works slightly differently compared to the others, you might just find one that doesn't bring on MOH as easily.

I myself have very limited experience with triptans. The only one I've ever tried in the past was Imitrex nasal spray. I had some rebound issues from that, so we axed it, and I tried Midrin instead, which works very well for me. I also had Ercaf in the past, but that's been off the market for several years, since it got discontinued.

If I was in your situation, and knew that I was prone to MOH with triptans, I'd simply look for a different preventative regimen that didn't involve a triptan. There are plenty of us that do have some preventative luck with things other than Frova and Amerge for hormone-triggered migraine. There are over 100 meds and supplements used for migraine prevention, and the odds are huge that something will be effective for you. Here's a list you can print and take along to discuss this with your doctor. You have lots of room for finding something effective that isn't a triptan.

Migraine Preventative Medications: Too Many To Give Up!

Last year, my neurologist had me take Amerge twice a day for two weeks to help me break a migraine cylce. I thought it was strange considering that we've always heard not to take Migraine medicines more that two times in a week. It helped to break my Migraines and I didn't have any adverse affects.

My normal triptan is Maxalt but sometimes it just doesn't work for me. I've never taken it more than two time in 24 hrs; twice in one week.

Just my two cents worth.

Hi there,

This question from our Ask the Clincian section talks about mentrual Migraine.Prevention of menstrual Migraines?

Frova has a longer half life and many people do well with it to help prevent menstrually associated Migraine.

I hope this helps.
Nancy

Menestrual migraines are brutal. (speaking from someone getting those ones right now and not happy about it) Even when I had the best control ever over my chronic migraines there was no chance it helped with those. Wierd, but true. So you end up taking triptans more than you usally would, because it is a week or more stright migraines. I have never had problems if I stick to the three triptan a week rule in regards to rebounds, but the suggestion for amerge taken daily to help with them might work. I know amerge is the one recomended, and before my migraines became chronic, and were more menstral migraines really, I was not it. Found it was one of the milder side effect onces and had no complaints. My doctor tried puting my me on strong anti-inflammatories daily and you might want to try that, if you can handle the anti-inflammatories... they can be brutal on the stomach. That same doctor for a bit put me on a water-pill, to I believe lessen the symptoms of my cycle. All I do now, which is not that effective, is juggle meds... a day on Axert, a day on just pain killers, a day on Axert/or my alt. abortive... and do what I can to not cause a rebound during the whole thing.

Yeah, Myth, that's pretty much what I do now - a day of triptan, a day of topical solutions (head on, icy hot, whatever I can put on my body while at work), then a day of triptan, maybe migranal the next day etc. But it last two weeks and gets really tiring, especially since the triptans knock me out so I'm just drinking a lot of caffeine to make up for the drowsines.
Anyway, thanks everyone for your advice so far. I am going to try 1/2 tab of frova 2x a day during my next cycle and see how it goes. I'm also going to meet with my gyn to discuss birth control options but that's a whole other can of possible side effects.
It's just a vicious cylce, folks...

Menstrual migranes for me are the worst ones - they last for 5 days, on average, with horrendous nausea. I get severely dehydrated because I cant keep any water down.

The only thing that has helped (in fact got rid of them completely), was to go onto a contracteptive pill that doesnt cycle (ie the dosage of hormones stay the same throughout the month) and I skip the sugar tablets so in effect, I never have a period. Ive checked with specialists, and I have been told that it is ok to do. So far, 2 years and no problems. I went off the pill once just to see what would happen - voila, a week of misery. Never again.

(However - keep in mind that if you have migraines with aura, you SHOULD NOT BE ON CONTRACEPTIVE PILLS AT ALL - the pill will dramatically increase your chances of stroke.)*

* Moderator's Note: This is a very broad statement. Many doctor, but not all agree. If you have Migraine with aura and use oral contraceptives, please discuss this with your doctor.

As I just posted on the other menstrual migraine thread, I get these too and yes, they're ferocious. I'm on top of (more or less) my CDH with topamax, nortriptyline, limited caffeine and exercise. I still get the menstrual-related migraine though. My neuro (Dr. Larry Robbins) thinks I should try botox and practice yoga for my nagging neck/should pain. Strongly considering both.

Anyway, after our phone consult last week (I'm about 3-1/2 hrs away from him), he prescribed a couple of NSAIDs for the menstrual migraine: ponstel and MigraTen. One of them is basically caffeine and aceteminophin he said, can't remember which. I'm heading into a premenstrual phase soon, so I'll post about my luck with these.

Beth

Good Morning Beth,

I too had menstral migraines and could not take any kind of hormone for them. I swear looking at the pill container gave me the migraine!!

My neurlogist did put me on Frova for the menstral migraines. Abortives, Preventatives.... This link will send you to an article on meds you might find helpful regarding this. I don't know if you can take abortives (as some can't) or not. But if you can Frova and Amerge both stay in your system longer than the others and have been sucessfully used to treat menstral migraines for that reason.

I hope the new program your doctor prescribed helps. They are nasty to deal with!!

Take care and good luck,

Cindy

Thanks, Cindy. I can't remember if it was frova or amerge, but I tried one of those a couple of years ago (after reading about them being used for menstrual migraine on this site) and had no luck at all. Because Dr. Robbins knew that from my intake form, after I told him no-go on hormonal birth control, he suggested the NSAIDs.