Migraine

Hey all, I'm posting a similar question in the non-migraine headache section too... as I'm still not confident I have a definitive dx. I'm trying to get ready for my next neuro appt on Monday. At my last appt my neuro started out saying CTH, then ended the appt saying it sounded more like mild migraine... while I fit more of the symptoms of NPDH. I know I've experienced some migraines for sure, I just don't know that's what it is all the time... or that that's my biggest problem right now. I'll be pushing him more for some definitive answers at this appt, since I've had the chance to try Topamax and a handful of abortives. I'm also planning to ask about some possible "rescue" meds to try. I feel like 1. I'd really like to experience some pay free time 2. Maybe if I could break the cycle, things might change.

My question is just what types of rescue meds are the most common. I haven't heard people talk about them much at all so far. I've tried a handful of different pain medications, with little or no success. Darvocet was the most helpful with a tiny bit of numbing, but codeine and NSAIDs felt like nothing. I usually go to my doctor with something in mind that I'm asking if I can try, so I'm looking for a little direction as to what I might ask him about.

Candance,

I've only used Vicodin and Fioricet, I like the Fioricet better, but you have to be very careful with overuse headaches. I am fortunate that I don't need them very often any more.

Cindy

I think maybe I took something like Fioricet early on in my headache... some generic combo of drugs.. it had codeine, bultabil and caffeine. Admittedly, I don't know a lot about pain meds.... I should know more! Does it make a big difference how much you're taking on how it affects you? I've been very, very careful with all my pain meds, as I was so nervous to become addicted to them, before I knew anything about MOH. I also grew up in a family who never used any medication, always went the natural way, so I always err on the side of caution with this stuff. I guess I'm just to the point where it's become a necessary evil!

Here's the deal.

The four steps to Migraine management, so to speak.

Identify and manage and triggers we may have.

Prevent Migraines from occurring.

Abort them when they happen.

Use rescue medications when abortives fail or can't be used.


So, topamax, inderal and depakote are preventives, imitrex, frova, and axert are abortives and fioicet, ultram and even the muscle relaxant skelaxin are rescue medications.
Preventive, Abortive, and Rescue Medications - What's the Difference? has lots of good information.

Like Nancy pointed out, there's a lot involved before we ever even get to rescue meds.

That said, my rescue med of choice is Lortab, which I also have for fibro pain, but I seldom ever use it for either, really. This though, is a for what it's worth thing, which isn't really worth a lot because I'm not you, with your specific med needs and interactions.

It would be better, rather than having a list of specific meds to ask about, to just tell your doctor you're interested in exploring rescue meds, point out the pain meds you've used in the past and your experiences with them, and then choose something together based on what you need and how you react to ones you've had. Rescue meds are generally pain meds, and your doctor likely already is well aware of that.

I have been using Meloxicam as a rescue med and it seems to work as well as Vicodin but w/o being stoned and constipated. That was after my MD gave me Tramidol while I was also taking Cymbalta and ended up with serotonin syndrome. Neither my MD or the pharmacist advised me not to mix the two meds.

Now I look up every new med before taking it. I found out the hard way that the docs and pharmacists don't always catch bad drug combos and that I have to look out for myself. One of the end results could have been coma/death.

So much for the computer cross checking the pharmacy advertises as a protection for thier customers.

Both the neuro and my MD knew I was using Imatrex also and they and the pharmacy never warned me about mixing it with Cymbalta.

Buyer beware!

Brent,

-:¦:-•:*'""*:•.-:¦:-•*Hello!*•-:¦:-•:*'''''*:•-:¦:-•*Welcome to the family!*•-:¦:-

If you get "stoned" on Vicodin, it's too strong for your pain. When the meds are appropriate to the level of pain, there is no "high" from them.

Wow! It would be VERY rare for the combination of tramadol and Cymbalta to cause serotonin syndrome unless ou were taking huge quantities of one or both meds. Tramadol works primarily by binding to mu opioid receptors. It only weakly inhibits serotonin reuptake. Serotonin syndrome is rare itself. How awful that this impacted you.

I find it very helpful to keep all the patient information sheets that come with my prescriptions. I punch them and put them alphabetically in a notebook. The information sheet you got with your Imitrex would have had a warning about SS and would have listed the symptoms, instructions about calling your doctor if you experienced those symptoms, etc.

Welcome again!

quote:

Originally posted by Brent:
I have been using Meloxicam as a rescue med and it seems to work as well as Vicodin but w/o being stoned and constipated. That was after my MD gave me Tramidol while I was also taking Cymbalta and ended up with serotonin syndrome. Neither my MD or the pharmacist advised me not to mix the two meds.

Now I look up every new med before taking it. I found out the hard way that the docs and pharmacists don't always catch bad drug combos and that I have to look out for myself. One of the end results could have been coma/death.

So much for the computer cross checking the pharmacy advertises as a protection for thier customers.

Both the neuro and my MD knew I was using Imatrex also and they and the pharmacy never warned me about mixing it with Cymbalta.

Buyer beware!

I was taking 2 100 mg a day of Imatrex while I was going off Topamax and tapering up on Cymbalta (60mg). After five nights of 1-2 hrs sleep and being completely wired/buzzing I found out not to mix the two. I can't read the ultra fine print that comes with the insert on the meds when my head/face/eyes are trying to rupture. But after dealing with that I won't make that mistake again.

Hi, Brent! Add a droolie welcome to the pile.

Thanks!