Migraine

Hi all,
I curious to hear from folks who have had good results from SSRI anti-depressants for migraine prophylaxis.
I have been on Prozac for several years for prophylaxis and it seems to be pooping out on me. Anyone had good results with anything else (without too many side effects)?
Thanks!

I tried three different ones several years ago, in my doctor's kind, but misguided efforts to squelch hyperthyroid mood swings. We also kind of hoped maybe they'd quiet the migraines down some, too. I tried Paxil, Prozac, and Serzone.

For me the whole anti-depressant thing was a big disaster. They made me depressed and emotionally flat-lined, which I wasn't before, even with the thyroid mood shifts (which was all hormones talking). They had no impact on my migraines. Serzone was really bad, and really scary stuff. I had visual hallucinations, horribly blurred vision, among a host of other nasties. We actually had to taper it off much more quickly than recommended, because it was so evil to me.

After that, I swore never to touch another anti-depressant again, for any reason whatsoever, including as a preventative. That's how bad my experience was. I still shudder some when I think about it.

Of course, this is another one of those take with a whole shaker of salt things, like I said in the other thread. I'm kind of a pro at uncharacteristic and atypical reactions to meds, after all.

I hope you have much better luck.

Well, I can certainly understand why you are reluctant to try another SSRI. Managing any illness/condition along with a thyroid disorder is tricky, since the thyroid is one of the "master glands."

Prozac got so infamous for "pooping out" that the expression Prozac poop-outs" is now often used to describe ANY drug losing its effectiveness.

As you know, so much depends on each person's reaction to meds.

Dr. Young switched me from Paxil to Effexor XR because he things the SNRIs have a better chance of helping since they address both serotonin and norepinephrine.

Ha! That's great! I first heard the term "Prozac poop-out" from one of the physicians I know. I haven't seen it in the medical literature yet, though.
I tried Effexor once several years ago and (for me, anyway) it was horrible. That is a good thought, though, as far as the SNRI's (you should go to medical school- you already know more than most of my classmates!).
I started taking Adderall not too long ago (the "student's little helper"), which seems to be helping a little with the norepinephrine lift it gives. Doesn't do anything for the serotonin, though. They should put SSRIs in the water.

Gotta love some of the expressions!

Darn! Sorry the Effexor didn't work for you. I feel really lucky in that I have major depressive disorder, and the Effexor XR manages that very well AND helps reduce the severity and frequency of my Migraines.

Glad to hear that the Adderall is giving at least a bit of help. You're not the first Migraineur who's said it helps. Hmmmmmmmmm. You don't happen to know a good neuropharmacologist there in KC, do you? I'm just thinking that such a person might be just the right person to recommend a good antidepressant to take along with Adderall. That's one of the things I most appreciate when I see Dr. Krusz. Since he's an MD with a specialty in neurology, subspecialties in Migraine and headache and pain management and a PhD in neuropharmacology, I can really pick his mind about meds.

LOL! Thanks. At this point, I think I'm a bit too old to manage medical school. As it is though, I love going to medical conferences and the chances I get to follow Migraine specialists around at times. They're great opportunities to soak up loads of info.

SSRIs in the water? Hmmmmmmm. I think I've heard that suggestion before -- and from a med student at that! You do know that if you need some support -- even if it's not Migraine related -- you can still come talk to us, don't you?

Keep us posted on which antidepressant you go with?

quote:

Originally posted by JayDocTC:
Ha! That's great! I first heard the term "Prozac poop-out" from one of the physicians I know. I haven't seen it in the medical literature yet, though.
I tried Effexor once several years ago and (for me, anyway) it was horrible. That is a good thought, though, as far as the SNRI's (you should go to medical school- you already know more than most of my classmates!).
I started taking Adderall not too long ago (the "student's little helper"), which seems to be helping a little with the norepinephrine lift it gives. Doesn't do anything for the serotonin, though. They should put SSRIs in the water.

Teri,

Does it also depend on what type of migraines you are currently experiencing as to which antidepressant may work best?

Just wondering because when my dr. DX'd me with transformed migraines, he seemed to know off the bat that adding the Amitriptyline to my Topamax would be or should be a good fit.....

He was right! I have reduce my migraines and TTH drastically!

I know that with depression disorders (anxiety,social disorders and such) each anti depressant (as do other meds) do something different, so is that the same for when scripting them for preventive treatment as well?

Does this make sense or no? LOL

I've seen that a lot of people take amitriptyline (or one of its "cousins") but I've always been reluctant to go that route b/c I hear a lot about unpleasant side effects. Now that my migraines are slowly getting better (at least less frequent) I'm a bit more conservative about what I want to try...

I tried Prozac years and years ago -- like 1990 -- for 3 weeks, and it was a disaster. I had good headache results with nortriptylene (Pamelor), but I gained 15 pounds, which was unacceptable.

I took Zoloft for several years, but I don't think it did anything for my head pain. I have Major Depression, so I'll always be on some sort of antidepressant.

I'm sorry the Effexor didn't work for you. I took it for several years. It did a good job on my depression; I took it with Wellbutrin. My head got better when I started the Effexor. I started seeing a specialist in November, and she switched me from Effexor to Cymbalta. I don't think that's made a change one way or the other. We started several different strategies at once, so there's know way to really tell which ones are working. But I haven't had good headache control since Christmas 1999, so I'll be aggressive.

I also take Moban, an antipsychotic. My psychiatrist says it helps people gather their thoughts better. And it's great for sleep. I take it at bedtime with Ambien.

If you want to go full-bore, I got good results with a combination of Nardil and Zyprexa. But I ballooned to 245 pounds. The Zyprexa was stopped for 3 weeks, and everything fell apart. I've been looking for the correct combo ever since. Nardil is an MAOI and requires lifestyle changes because of food and drug interactions.

That's probably much more than you wanted to hear.

Gretchen in Mississippi

The Amitriptyline/Topamax combo for me, has been wonderful for my head!

Of course with every ying, there is the yang.

With the Amitriptyline, I feel like eating everything in the house (and this is on 20mgs at night). I have been on it since 1/08 and maybe gained 2.5 pounds? I go up and down with the same 5 all the time. The Amitriptyline does give me a better sleep though, I do take it with Melatonin (which I cleared with my doctor) so I think that has helped my transformed and TTH as well.

The Topamax wasn't working at all anymore till adding in the Amitriptyline - the weight loss with the Topa was great, but now with the Amitriptyline that has just stopped. Also the good 'ol libido isn't what I remember it pre topamax.....and it'd be GREAT to get that back!!!

I was hesitant to try the Amitriptyline because of the whole weight gain thing, but considering I can now go almost 2 weeks without a migraine, I'll take the extra weight.

So, I asked my neuro about changing SSRIs and she said that antidepressants often make migraines worse. I was surprised to hear that, since so many people seem to take them for prophylaxis.
Has anyone out there had worse headaches on antidepressants?

Effexor XR (300 mg), Trazodone (300 mg), and Topomax (200 mg) seem to keep my depression at bay and my migraines down to 5-6's and 2-3/month. (The Trazodone and Ambien, 20 mg, are to help me get decent sleep.)

Of course, with the spring thunderstorms, fluorescent tube lighting and other triggers at school and at home, I've been on a real rollercoaster lately!

Critter population is up by 1. We now have a 6 month old Dachshund! Winston is a semi-long-haired, chocolate and red delight. DH brought him home Fri., and when he and youngest DD saw each other, it was like some sappy TV show! They literally ran to each other!

May all y'all sleep well and pain free tonight.

Rebecca of the Island