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Topamax and Vivactil for chronic migraines

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Posted

I'm taking 200 mg of Topamax and just started taking generic vivactil (protriptilene) as a 2nd preventive for chronic migraines.  Anyone on a combination preventive regimin similar to this.  We (my headache specialist) and I just can't seem to get my head to stop hurting.  I have been having long runs of migraines and having to take more than 2 triptans a week, which is a big no no... causes MOH...and I dont want that again..  Don't really find much info on protriptilene on the internet, other than a few posts on this website...

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Posted

I was told not to use triptans too many times per week because of rebound headaches, but was not given a hard and fast rule, other than the second dose had to be 2 hours after the first, and no more doses can be taken after the second one for 24 hours. Oh, and also that you can't take two types of triptans with 24 hours of each other, but that was it.

 

What is MOH? Is MOH some kind of serotonin syndrome? I'm going to be annoyed when I find out, because I am pretty sure it is going to be a really obvious acronym that I am just not pulling out of my ass at the moment.

 

I have been on Zonegran (a metabolite of Topamax), and it damaged my kidneys, so that ruled that out, as well as Topamax since they are related. It wasn't working for me anyway, but Topamax is my sister's silver bullet, and she lurves Topa.

 

I have tried a tricyclic, but not that one. I tried Pamelor. It fucked with my mood within two weeks, so we backed off of it. There are others on the boards on tricyclics, and a ton of people on Topamax, hopefully some of them will chime in.

 

You still have a lot of prophylaxis to try, what else have you tried?

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Posted (edited)

MOH is usually Medication Overuse Headache. I've taken both those, though I had to quit the Topamax before any result could be seen. Vivactil had no effect on my migraines or depression. It did make me wired though.

Edited by helloheartbreak

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Posted

Oh! I knew that that happened, but I didn't know there was an actual name for the syndrome. I had that for a while, but I stopped taking analgesics when it finally penetrated my thick skull that they did nothing for pain, and were making things worse.

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Posted

Yes MOH is rebounding or medication overuse headaches which is what started my chronic migraine hell.  I have been slowly tapering up on topa to the 200 mg and just have not seen the headache control yet so we added the vivactil in.  These are the 1st meds I have ever tried.  Never had to take preventives before.  Thanks for your comments!

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Posted

Oh I might have had that happen to me before, the MOH. 

 

I have taken: Frova, Imitrex, Topamax, Depakote, Propranolol, Hydrocodone, Pamelor, Vicodin and some other triptans to help with my migraines.

 

Pamelor made me homicidal and depressed. 

Frova was cool for my PMS Migraines and then I realized my periods last 11-15 days so I couldn't take that many triptans.

Depakote was introduced about 5 months ago. In actually thats when I started getting more headaches.

Imitrex took everything away, but I had to choose between imitrex or lithium for mental health, and I chose lithium

Hydrocodone/Vicodin I am always given at the ER or while i am IP because I am put in so much pain. But I don't take too often cause of rebound headaches

Propranol...my ndoc had me try it in the office. I passed out at the end of the session.

 

My current regimen is Topa, Depa, Pain Meds. Its not working. Doctor wants me to do Botox or nerve blocking. Fuck.

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Posted

Wow Cfranco, looks like you have been through a few meds...  The vivactil addition to the topa has given me 5 days of 0 headaches so far so other than some blurry vision side effects, I am about to throw a party for the generic version of vivactil (protriptyline)!  I think my doc has found my combo to relieve my migraine hell!  I hope it lasts.   I have heard good things about Botox...  

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Posted

Botox is nearly on the level of being a miracle for me.

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Posted

I wish Botox were for me. It clearly makes a difference, but it isn't reliable, jut improved.

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Posted

I agree with that - especially when I moved and got a new neuro and he had his own injection scheme, for the round after that I had to go back and pretty forcefully be like no, listen this is the placement that works for me. But still, reducing me to 5 migraines a month from 20+ is life changing. I'd rather take a preventative in a pill form but I've failed everything, at least everything that was available up to about 3 years ago. Migraines are a special hell.

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Posted

I am apprehensive about nerve blocking and Botox. I mean, crtclms, I know we have different kinds of migraines but I feel we have a very similar journey. I do not think botox will reduce my migraines, especially for how much they will cost per month. And I am not exactly sure what nerve blocking is...all my ndoc said was I would be seeing a general anesthesiologist.

 

Which makes me a little uncomfortable. But I can handle the 2-3 headaches/migraines I get per week right now until ndoc and I figure it out.

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Posted

cfranco, I just heard about nerve blocking myself, and I have to look at it some more. My pain Dr is actually an anesthesiologist, too.

 

Also, botox made my headaches worse the first time I tried it, but as I said, they markedly improved the second time. Last month I had my 3rd round done in the hospital with a huge amount of it, they even put it at the base of my neck (like actually on my back).  This time, the Dr. who did the botox felt around until he found the exact muscle he was looking for.

 

You know, I'm so grumpy about the DHE not being the miracle I thought it would be, I haven't really been paying attention to the botox this round. Most of my headaches since the hospital have been pretty low-grade, which could as easily be because of the botox as the DHE.

 

I have heard some people say botox was their silver bullet. But to be honest, I have mostly heard people saying it improves, but doesn't eliminate them. Then again, my friend for whom it completely worked is extremely, extremely happy.

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