Migraine

I've run into a new question concerning MOH in one of the other threads. Well, two actually.

First, I realize that any med used for headaches can cause MOH... so the more serious ones and simple aspirin. However, is the naproxen I was given just as likely to cause it as a triptan or darvocet?? I just have Naproxen 500mg... which is such a baby med I wonder if it's that serious to use it, although I've avoided it just to save my stomach lining, not just for MOH reasons. Does it pose just as much of a risk, or is it harder to create MOH with the lighter drugs?

Secondly, I've heard the no more than 2-3 times a week for any of those meds... but what if you alternate? Can I use Relpax two days this week and Naproxen three others?

Thanks!

Ask your doctor (I realize this can be problematic for you right now), but most doctors will let you take a triptan two or three days a week, and a pain killer two or three other days a week. Naproxen is at least as likely to produce MOH as a triptan. Acetaminiophen (Tylenol) is one of the worst MOH culprits, and it is an ingredient in Darvocet. In fact, be careful with any "combination" meds that contain two or more different meds. Not only for MOH reasons, but to be sure you don't unintentionally get too much of one of the ingredients.

I guess you've seen the MOH article before, but here it is again:

Medication Overuse Headache - When the Remedy Backfires

Good luck.

Actually - the less harmful (or so you would think) meds such as OTC's like Advil and Asprin are usually a bigger culprit for MOH. I think maybe because we think "oh, it's just Advil" and take 4 instead of the 2 it says.....????

And yes alternating is a good way to potentially avoid MOH.

To be honest with you, I don't even take any OTC anymore.

And there is muscle relaxers too, they do not cause MOH, which is my saving grace!

Maybe looking over the article Preventive, Abortive and Rescue, what's the difference? Just because it explains about rescue and abortive drugs a little more.

Just to add my 2 cents in here... IMHO, MOH is just about as close to feeling like you've lost control of the migraine monster as hopefully you'll ever get. Trust me. Please be careful? I'd hate to see someone else have to go through this!

Ok... I really haven't been playing around with my meds much at all... mostly just because I haven't gotten any relief at all from anything yet. Now, I haven't tried the Ultram yet... but I was asking about how to go to the gym and get my heart rate up without getting a horrible migraine afterwards and someone suggested to take an abortive BEFORE... but of course I could only do that 2, 3 times a week. So then I wondered... hey, maybe something as small as Naproxen might work, maybe I just need a little help?? I can't tell you how badly I want my old life back! So I feel like I understand the different drugs and their uses in general, I just ran across this possible other reason to be taking them... hence the question.

I haven't been taking the Darvocet... in months, the old neuro wanted me to quit it, and I only took it once every other week or so anyways, so it wasn't hard to do.

Ok, so I'm hearing you say when I do take an OTC, I should only be taking 1 or 2, the dosage is important? I had never thought of that. I have been using them a little, not for head pain really, cramps, days where I could use a little anti-inflammatory help.

I plan to talk to my new neuro about muscle relaxants... I was hoping for one at my last appt, but ended up with the Ultram instead.

I second that feeling!!! MOH is the worst thing I've ever felt - ever! And I just waited mine out because it hit on a Sunday no Dr. office is open Sunday and I didn't want to do the ER thing....I didn't think they would really understand....

Keeping my hand out of the proverbial "cookie jar" was the hardest thing of all though. I wanted to take something so bad, but I couldn't. I really should have gotten help from a doctor in hind sight.

quote:

Originally posted by JamieHOST:
Just to add my 2 cents in here... IMHO, MOH is just about as close to feeling like you've lost control of the migraine monster as hopefully you'll ever get. Trust me. Please be careful? I'd hate to see someone else have to go through this!

My feeling on this is if you take a triptan before, and you don't get a migraine - great. But what if you max out on triptans and then you get a big mamma jamma and you can't take anything because you used all your triptans as "just in case"? Plus - they are expensive too!

Maybe asking your doctor about this before you use this practice would be a better bet. Maybe he/she can suggest something else.

I feel ya on the working out. I just don't do it anymore. Anything that jumbles the brain around, like cardio - kills my head. I can walk and stretch, oh and sit ups, that's pretty much my limit. And I used to be the kickbox queen! I just can't anymore, not with my head now.

quote:

Originally posted by Candace:
Ok... I really haven't been playing around with my meds much at all... mostly just because I haven't gotten any relief at all from anything yet. Now, I haven't tried the Ultram yet... but I was asking about how to go to the gym and get my heart rate up without getting a horrible migraine afterwards and someone suggested to take an abortive BEFORE... but of course I could only do that 2, 3 times a week. So then I wondered... hey, maybe something as small as Naproxen might work, maybe I just need a little help?? I can't tell you how badly I want my old life back! So I feel like I understand the different drugs and their uses in general, I just ran across this possible other reason to be taking them... hence the question.

I haven't been taking the Darvocet... in months, the old neuro wanted me to quit it, and I only took it once every other week or so anyways, so it wasn't hard to do.

Ok, so I'm hearing you say when I do take an OTC, I should only be taking 1 or 2, the dosage is important? I had never thought of that. I have been using them a little, not for head pain really, cramps, days where I could use a little anti-inflammatory help.

I plan to talk to my new neuro about muscle relaxants... I was hoping for one at my last appt, but ended up with the Ultram instead.

Hey there.

I don't have the answers on the rebound headaches but I do know a bit about Naproxen 500mg. I take it for my back.

It is not a small harmless med. Sure, its not a narcotic but it is on the stronger side of NASAIDS. I've got a stomach of steel but if I exceed the recommended dose of one in the morning and one at night it causes cramps and stomach pains.

OTC version of it is Aleve. A pretty good medication for my back but again one has to be careful. It is stronger and tougher on your body then advil and harder on the kidneys so my Doc says.

My wife can't take NSAIDS or TRIPTANS for her migraines due to other health issues so we are unsure if it would cause the whole reboud thing.

Perhaps compared to the migraine abortives and rescue meds Naproxen is "small" but as far as NSAIDS go it is one of the heavy hitters.

Peace,

Dave

Dave, thanks for the input... I did talk to my PCP about the naproxen, I was very hesitant to take it when I got the script... I have a sensitive stomach (although nothing is officially wrong with it)... I have acid reflux, just due to a "lazy throat" if you can believe it. He told me that *if* I take it with food, I should be fine, but that it can do a lot damage if taken without.

I grew up in a home that was very anti-meds... I took a lot of homeopathic, herbs, etc... antibiotics were an absolute no-no... so it's weird for me to take so many meds now, but I view at a necessary evil. I'd always rather not, and I'm always looking for the root problem and solution. I also want to be as easy on my body as possible. I try not to use an inhaler if I don't need to, avoid steroids.. they break down your connective tissues, which since I have a connective tissue disorder--I want to keep mine as healthy as possible!!

Eileen, when I've had what I am 110% confident are migraine ATTACKS I've tried the triptans and they haven't helped... so I guess I figure, what do I have to lose in trying them for something else? I do want a doctor to talk to about these things though... my appt is coming up (yay!!) in a month with the new neuro. I really don't want this to be the end of me and working out though, I'd like to think that this head pain doesn't have to mean my life has to change that much?? Maybe I am playing with fire... I guess I've felt like I've been very good at being safe, as I explained above, I'm very moderate with medications, I don't like to take a lot of anything... so trying this at all is unusual for me.

People have used indomethacin for exercise-induced migraine attacks and headaches. Ask your doctor about this. It might be a good answer for you. And search for it on the site. I'm almost sure there was an Ask the Clinician answer on it.

Ironically, if I have a small headache, getting out and having a brisk walk can make it better. Even going outside with a severe migraine is a no-no, but the ones from 3 to maybe 4 can be helped, temporarily, with a nice walk. I don't know whether it's the increased heart rate, being out in the weather, being out in the nice, fresh air, or spying on my neighbors that does it, but it can help.

I hope you find a solution soon. I get antsy if I can't get my walk in for several days.

Gretchen in Mississippi

Candice,

How many Triptans have you tried? And they all have failed?

Check this link out about Pseudotumor Cerebri or IIH and see if this may fit you....

Yes, OTC meds can be dangerous, because of MOH and for other reasons as well. That's one reason it's important to clear all OTC meds, supplements, etc., with your doctor. Some supplements will interact with other things the doctor wants you to take.

I got a gastric ulcer from ibuprofen--and I ALWAYS took it with food. Now, since Tylenol does me about as much good as drinking a glass of water (actually, probably less), my GI doctor has me take OTC Prilosec whenever I really need a NSAID. You might want to discuss that option with your doctor.

Tylenol is a very safe drug within the recommended dosages, but the spread between the therapeutic dosage and the maximum safe dosage is not that wide. And it is very dangerous to exceed that recommended dosage. See this article:

A Mother's Plea:

Hi Eileen,

I've only tried Immitrex, Zomig, Frova and Relpax. I'm not *certain* the Relpax doesn't work yet, as it *may* have staved off a migraine the last time I went to the gym... I'm not quite sure. I just haven't had a chance to ask for another abortive to try yet. That's on the list for the neuro. This question just came to light since I was trying to some of *me* back by going to the gym.

I've considered the PCT before... but I think I discounted it because my eye exam was normal--but then I read that the eye test isn't conclusive! It goes back on the list for the new specialist. Poor doctor... my list is going to be LONG. I think actually I'll just be letting them explore my symptoms and figure it out themselves, because I'm honestly pretty baffled by it. NPDH fits it best by what I can tell though. I have near perfect hearing... just had it tested last week.. so PCT has a flaw already... and am by no means overweight, and haven't been vomiting... the others though.

Thanks Nutcracker... what a heartbreaking article. I certainly wouldn't ever be messing around with those types of doses. I attempted suicide when I was in high school with Ibuprofen (so not only is the stuff pretty useless to me now... I can't stomach it at all). I guess I was asking more in terms of 4 vs 2 when it comes to MOH. I've only ever taken 1 at a time of the Naproxen... I took more this week than I've taken at all, 3 in two days, about 12 hours apart.

My PCP said I'd be fine with the Naproxen... but I'll admit I still feel a bit wary of it for tummy reasons. I'd be willing to venture that way a few times for a workout or two though! Can't even tell you how badly I want to feel some sweat again! It was wonderful to feel that rush after my workout... of course it was followed by absolute misery...

I'm hoping to come up with some sort of plan for NOW.. but if not I'll be loving my new doc if they can get my heart pumping without my head following suit!

Hi Candace,

In theMedication Overuse Headache - When the Remedy Backfires on page 2, How to Avoid MOH, may be what you are looking for. Let me know if it anwswers your questions.

This Ask The Clinician Question may be helpful too:
Preventing exercise triggered Migraines?

Have you tried keeping a Migraine diarylatey? Sometimes seeing things is writing gives us a clearer picture and our Migraine patterns can change over time.

Candace- Just wanted to reiterate that I feel for your situation. I'm guessing that you may be suffering from depression(you mentioned a suicide attempt above). I know for myself I was diagnosed with clinical depression many years ago. Exercise is not just an "outlet"- it also raises serotonin levels and releases natural endorphins, which is critical for someone who suffers from depression!
So keep plugging away at this and don't give up this area- I haven't, and yes I still get migraines- I've cut down on my running but have not given it up. And there will be an answer for you!
Valerie