Migraine

Hi,

I'm new on this board, but have been on other boards, and have been researching this darn disease for what seems like forever (although it's only been 6 months). I have chronic daily headache, interspersed with more acute migraine attacks. Topamax, verapamil, and dietary changes have cut back on the acute attacks. Cymbalta was added to my cocktail but it absolutely killed my sex life, and I just can't take it. Although my boyfriend is very understanding and supportive, it hasn't been great for our relationship, either. This disease has robbed me of so much already - food I like, the freedom of being able to eat out and shop at a regular grocery store, alcohol, my workout routine, not to mention the money I've spent on treatment, meds, supplements, and more expensive food. Anyhow, many of you are quite familiar with that gripe list, plus much more.

So I started going off the Cymbalta, and sure enough, the daily headaches are back. So, obviously, it's the increase in serotonin and norepinephrine that's helping, which would indicate either another SNRI or a tricyclic, but I just can't risk the weight gain with the latter. I've had a weight problem all my life, I'm at extremely high risk for diabetes, and I haven't been able to do more than gentle exercise for months. I've lost a lot of weight from the combination of the Topamax and the dietary changes, but I could stand to lose another 20, at least, and I certainly can't afford to gain any back.

So a couple of questions for people: Does anyone know if Pamelor is any better than Elavil in terms of weight gain? Is it possible that I might have better luck with sexual side effects on Effexor? I'm kind of doubting it, because I've taken SSRI's in the past for anxiety and that nasty effect has reared its head every time, almost as soon as I put the first pill in my mouth. But I've read that with Effexor it sometimes goes away on higher doses.

Thanks!

It sounds like our symptoms are similar. Chronic daily headache, with one or two migraine attacks a week. I've been on various preventives for 18 years, with varying success.

Pamelor was the first preventive I tried, in 1989. As I remember, it was fairly effective. However, I did gain weight, which was unacceptable at the time. I tried a brand-new drug (back then), Prozac. That stopped the weight gain, but the 3 weeks on Prozac were a disaster. All my symptoms returned, worse than before.

I suffer from Major Depression in addition to the CDH and migraine disease. I'm currently taking Wellbutrin and Effexor as my antidepressants. They've been doing a good job. I started Effexor several years ago, and I don't remember its effect on my love life. If it were a big negative, I'd remember it.

I've been married for 26 years. DH is taking Wellbutrin for his depression and also for REM sleep disorder. He was taking Cymbalta, which was doing well on his mood but was causing other sleep problems. [He also has a CPAP, which has changed his life.]

He's been on Wellbutrin for several months. His libido increased greatly when he first started the Wellbutrin. I had the same experience when I started taking it. Unfortunately, that dwindled after a month or so, but we're both a little more receptive to lovemaking. Certainly not like newlyweds, but fairly healthy for married folks in their 50's.

Effexor and Wellbutrin have been weight-neutral. Like you, I can gain weight without any help from meds. I'm about 70 pounds overweight and am doing Diet Center (recommended by my primary care doc). I'm 45 pounds down from my peak weight.

I tried Topamax, and I lost a lot of weight. However, it zonked me out -- I felt like I had a virus the entire 9 months. I even ran a low-grade fever. And it made my head worse.

Have you thought about some of the other anticonvulsants? Depakote put a lot of weight on me, but I'm currently taking Lamictal, and it's been weight-neutral. Some of the folks here have had success with Zonegran.

I'd have loved to stay on the Topamax to get all my weight off, but I felt so bad that I had to move to something else.

You're doing the right thing by researching and learning all you can about migraine disease and head pain. Hang in there!

Gretchen -- gretp

Well, first off Welcome to MyMigraineConnection. I completely hear you on the weight thing. As a matter of fact I was just at my docs yesterday asking to switch from the "weight neutral" Cymbalta (HA HA HA.) "Oh, no, if you are feeling better than just diet and exercise." She replied in her perfect size 4
So, to answer your question. Elavil made me gain weight, a lot of it, so I can't go there again. Wellbutrin -worked ok, no weight gain. Effexor, didn't have such good luck on.
Now having said all that, everyone does not experience all the potential side effects that are listed. If we did meds would never get approved! That is an important thing to keep in mind because you don't want it to become a self fulling prophesy so to speak.
Let us know how you make out.

Well, I decided to titrate my Cymbalta dose back up again, since it seemed to be helping, and look for other solutions to the sex issue. I noticed some improvement in my headache the first day I was back up to 40 mg. Of course, I was foolish enough to eat something I shouldn't have, so now I'm paying

I did a little more research, and it turns out there are several treatments for antidepressant-induced sexual problems. None have been systematically researched, but several have some decent anectodal and case series evidence. Gingko bilbo counteracts the side effect in many cases. Also, Buspar and Wellbutrin can be added to an existing medication regimen to reverse the side effect. Ritalin can be taken on a prn basis, because it's so short-acting, but it seems to me that the stimulant properties of this drug could present problems for a lot of migraneurs. There are a couple other remedies, too, but they have formidable side effects. Also, Viagra has been tried for women and has worked in case studies, but again, this would seem problematic for many of us headache folks. Unfortunately, all of these options have only been looked at in depressed patients, not migraneurs, so it would be really important to consult with your neuro before trying anything.

Anyhow, I plan to make an appointment with my neuro to go over the options and see what he thinks. My first thought is that Wellbutrin may be my best option. I took it years ago for depression without any problem, and from what I've read, it's effect on headache/migraine is typically neutral.

Since I developed chronic headaches about 7 months ago, it feels like my life has been turned upside down. There have been times that I haven't even felt like myself anymore. I know everyone here can relate to this. I've tried *so* many meds, have experienced a gazillion side effects, went through a period where my income and my work life took a serious hit, have had to give up my exercise routine, and my love of wine. And then I discovered that MSG was a huge contributor to my headaches and so have had to totally change how I eat and shop for food, giving up a lot of my favorite foods and restaurants. But, dagnamit, I'm drawing a line on the sex life!!!

My DH takes Buspar for a much shorter temper than is usual. It has helped.

Don't forget that if a side effect is listed, and even if one of us has had that side effect, it's no guarantee that you'll have the same trouble. Did you know that one of the listed side effects for Imitrex is headache?

I try to make it my policy not to be afraid of a med because of POSSIBLE side effects. I'm taking Lamictal, which has a Black Box warning about a potentially fatal side effect. I haven't had any problems. "Potential" means just that. I'd hate to pass on a med that might be of great help.

Hang in there!

Gretchen -- gretp

Yeah, I generally have been willing to try whatever's been suggested, but I am *so* tired of all the side effects. And the regimen I'm on, plus the diet did seem to be working. Surprisingly, I seem to tolerate Topamax better than a lot of people, although it took months for the sedation effect to wear off. But with other meds I've gone through dizzy spells, constipation, insomnia, wicked dry mouth, and itching. Sleep meds made my headaches worse, plus made me sleepier during the day. Neurontin made me so loopy I couldn't drive. And then Inderal caused me to get severely depressed for over a month before I figured out what was going on and asked to be switched to something else. And now the sex thing. I guess I'm starting to get rebellious...

I am so glad to have found this site! I have been on elavil for 10 months and gained 16 lbs! I was doing great on Topomax but it was very expensive. My neurologist switched me to Elavil since it has a generic version. It worked great on my migraines but the weight gain is intolerable! I just switched to Inderal a few days ago and have not had any problems yet. For those of you that were on Elavil and gained weight, did the weight drop off fairly quickly after you got off it? None of my clothes fit, it's so frustrating!

Hi cherie,

Welcome to the forum. We're glad you found us too.

I took Elavil for a while and gained weight too. Sorry to say the weight did not drop off easily for me, but it may be different for you. I know how frustrating weight issues are!

Inderal is a beta blocker that is used to treat Migraines, and is very effective for some people. There are many medications that can be used to treat Migraine disease. If inderal isn't the right medication for you there are more available.

Keep us posted and we look forward to hearing more from you.