Migraine

So once again I am back in the swing of a horrendous migraine, and I'm wondering how to decide what to do. I've had this migraine since yesterday, and today it has become truly unbearable. The last 5 times I've taken imitrex though, it hasn't done squat, and i've taken it 5 times in the span of the last 2.5 weeks.

So do I take one and risk MOH, despite the fact that imitrex hasn't been working lately? Or do I try to figure out another triptan (or something else) to try instead? How do you decide these things? I'd love to hear your thoughts

I can't take triptans, but I have four medications to choose from and switch them up to avoid MOH.

This is a question for your doctor - if you think Imitrex is not working, there are six other triptans to choose from. Just because one doesn't work doesn't mean the others won't. Good luck.

Thanks Deb!

Hi e,

I think the "When do I take my abortive?" question is a really tough one for many of us! I know it is for me! I'm a chronic migraine with aura sufferer--I have migraine pain most every day.

Obviously, I can't take my Imitrex every time I have a migraine--I'd be in MOH for sure! I typically wait to see just how bad it's gonna get before I even consider taking it...I know that's not the best way to take a triptan, but I really have to be careful! I only have a few Imitrex to use each month and I really need them for the toughest of days!

Like Deb, I also have other meds I can use if the migraine is bad and I've taken my limit of imitrex. I try not to use them too often, but I will not even hesitate to reach for them if the migraine is truly severe.

As for whether to take the Imitrex when it hasn't been particularly effective, I'm with Deb. If your Imitrex is really not helping at all (and hasn't been for quite some time), I'd call your doctor and ask him/her about trying another abortive.

With so many choices, why stay with one that's not working?

If you do think the Imitrex has a chance at working, I'd probably take it...I know we don't want to risk MOH, but an occasional "slip" probably won't do much harm...Just to be sure, you could always call your doc and ask the nurse what she thinks would be best for you!

Feel better soon, e!

jenny

Thanks jenny! I realized after I posted last night that it had been awhile since I'd taken ibuprofen, so i took 800 mg and took a nice hot bath, and that helped relax me and bring down the pain enough to let me sleep. Luckily, the pain has not been that bad today

What other meds do you take? I'm trying to research everything and have a list of options before I meet with the neuro on monday, so I'd love to hear about what others are doing. It seems like everyone has widely different experiences with abortives.

Hi again, e!

quote:

What other meds do you take?

Well, I have a few different treatment options. I have imitrex injections and maxalt melts. I try to conserve the imitrex shots-they are very expensive for me! And i can't use these two within 24 hours of one another, so that limits my choices, too.

I also have a few rescue options...I have Ultram (a non-narcotic pain med) for migraines that are pretty bad and are unresponsive to the imitrex. The Ultram really doesn't relieve the migraine pain--it just takes it down a couple of notches and makes it easier for me to sleep.

When my vomiting becomes excessive and REALLY severe (like it lasts a couple of days with unbearable pain), I have a shot of a med called Droperidol. I also have prescription Benadryl and Ativan that I take with it. (Without the Benadryl and Ativan, I feel like there are bugs crawling all over my body...the droperidol is definitely not fun!).

Those are my best options when things are really lousy...

jenny

I take either Imitrex or Frova as my abortives, and my neuro and headache specialist have both recommended that I take them with 400 mg of ibuprofen. I've found that they really don't work without that dose of ibuprofen for me, especially since I have a constant level of pain - so, typically an abortive wouldn't work since I can't take it at the "first sign" of my migraine.

I still have a long way to go on an effective preventive/abortive/rescue plan though. I haven't found effective preventives yet; my abortives work decently, but I max out on them most weeks; and I still need to discuss rescue options with my specialist. So I'm still a work in progress.