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migraine prevention options


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I tried looking for this topic and didn't see anything great that was relatively recent, but let me know if I missed something.

Can anyone run through some of the most widely used migraine prevention medications?

I was on doxepin, but went downward because of weight-related issues and then got taken off it abruptly while IP.  I had attempted to start zonegran but got an allergic reaction to it after two attempts that I couldn't wait out to see if it stops.  I've taken topamaax before and it was a sugar pill and I'm too terrified to depakote to add it in when I already have the lithium, lamictal, and seroquel (to name a few).

If you have something you use, do you mind talking about what it helps with (if anything beyond preventing migraines)?  If you've had a bad experience, that would help too.

I left a message for my neurologist and there's a chance he might want to wait and see if it's really still a problem...I hadn't had any for four months, but I was also on either topamax or doxepin the whole time.  Since IP and stopping it, I've had a few headaches, but no migraines...but I'm worried it could go in that direction because that's how it started before.

Thanks!

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A very pleasant side effect of my Tegretol is that I no longer get headaches of any kind, and I used to get killer headaches believed by my doctor to be migraines. I have found Tegretol kinder and gentler than Depakote and has much less "dumbing down" effect than Topamax.

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Idk what gives me migraines, except the ones that follow a tension headache that I didn't take care of to begin with.

One thing that helps me is being on flexeril (that will mainly help more for the tension headaches to get rid of so I can try to prevent a migraine from that angle).  If I take the muscle relaxers I have to be able to sleep right after taking them or it makes the headache worse.

Another thing for me is using ice packs.  Any kind of ice pack, but I have an ice pack with a light scent of lavender, and even the lavender helps my head to relax (I can actually feel my head relax).  So maybe something like lavender would help?  That is just a guess based on personal experience though.

Sometimes I need excedrin, sometimes not. Depends on how I feel.

This also works for me in an instant:

https://smile.amazon.com/gp/product/B00U0DH708/ref=ox_sc_sfl_title_24?ie=UTF8&psc=1&smid=ATVPDKIKX0DER

HOWEVER I save it for the worst because I don't want to end up relying on it for every headache.

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I know a whole slew of possible armor to fight off an existing migraine, but preventing them is a horse of a different color.

Besides the usual: keeping stress anxiety level low, avoid extreme temperature changes or pressure changes if possible, no icy cold food, no artificial perfume or fragrance, use Arm& Hammer laundry detergent, avoid anything and everyone that triggers your migraines.  Also, I use a direct hard stream of water as hot as possible in my shower. I like hot on my face & sinuses when I am feeling migrainey. I also use Tiger Balm extra strong around my hose.

Most importantly, Propanolol is the first med that seems to be preventing my migraines. I take very little, one pill in the morning and night. Somehow it is helping but I still don't believe it.  My pdoc sent me to a neurologist for fiorinal (part of my med arsenal) and he suggested propanolol as a prophylactic. 

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Quote

Most importantly, Propanolol is the first med that seems to be preventing my migraines. I take very little, one pill in the morning and night. Somehow it is helping but I still don't believe it.  My pdoc sent me to a neurologist for fiorinal (part of my med arsenal) and he suggested propanolol as a prophylactic. 

Yes ... propranolol for me too ... forgot to mention that one.  But it does not prevent my migraines.  I have that as needed when I feel one coming on, but when I do take it I need to be laying down to try to rest while the propranolol works.  And that usually works for me.

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Thanks water and Melissa.  Water, that's a really long list of ideas, so many thanks.  I may bullet point them onto a note card along with some of the other ones above.

i hadn't heard of propranolol for prevention...is that the one that also helps with anxiety?  Or just the tremor stuff?

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2 hours ago, dancesintherain said:

 

i hadn't heard of propranolol for prevention...is that the one that also helps with anxiety?  Or just the tremor stuff?

Propranolol is a beta blocker, but it helps with headaches/migraines, anxiety (for me at least), and tremors.

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3 hours ago, dancesintherain said:

Ahh that's the trick then. I can't use a beta-blocker and still get allergy shots, I don't think.

I would ask about that.  Maybe you could even call ahead and ask. 

I think the allergy shots would be given by the same DR as asthma would.  I have asthma and beta blockers are not recommended for that but my DR allows it.  I keep a close on how I am breathing, and if it is too much (increasing inhaler use) I know to go down on it.  I think the only time I could not take them was before the skin prick tests.  Otherwise it was ok.

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Besides the options you mentioned, you might want to try verapamil, which is a calcium channel blocker. Also, cymbalta (a very small amount) and tricyclics. I'm taking Zanaflex nightly, but I'm kind of past the regular meds and I'm taking it more because it relaxes me and helps me sleep.

Depakote worked really really well for me, it was the best of any of the other meds I've taken. But it stopped working.

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I can check melissa--I had thought it was a complete ban because of the frequency of the shots, but maybe it's just a notify your doctor situation.

Thanks for the extra ideas crctlms--the IP pdoc suggested I stay away from all anti-depressants whatsoever (and yet claimed wellbutrin was okay to consider resuming because of not being likely to cause mania as much as the others).  That didn't really seem to match my knowledge/experience, but I'll be leaving it in the hands of my neurologist and pdoc anyway.  He may just want me to wait and see, but given that I'm already getting at least twice daily headaches and some seem more like tension headaches, I wouldn't be a huge fan of waiting for the shoe to drop. 

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7 minutes ago, dancesintherain said:

I can check melissa--I had thought it was a complete ban because of the frequency of the shots, but maybe it's just a notify your doctor situation.

Thanks for the extra ideas crctlms--the IP pdoc suggested I stay away from all anti-depressants whatsoever (and yet claimed wellbutrin was okay to consider resuming because of not being likely to cause mania as much as the others).  That didn't really seem to match my knowledge/experience, but I'll be leaving it in the hands of my neurologist and pdoc anyway.  He may just want me to wait and see, but given that I'm already getting at least twice daily headaches and some seem more like tension headaches, I wouldn't be a huge fan of waiting for the shoe to drop. 

Just wanted to say that what your DRs said about the wellbutrin doesn't match my experiences either, but definitely go by what your pdoc and neuro suggest.

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So @crtclms, I've actually ended up on the same medication as you at least temporarily.  It sounds like for different reasons though?  My neurologist's thought was that because of the location of the headaches (back of head extending to sides slightly, with some neck tensions and stiffness seemingly related; front of my forehead), the fact that psych stuff is possibly contributing and likely to get played around with, and the fact that messed up sleep is possibly also contributing, it would make sense to use a medication that can gently help relax the muscles that could be causing it, that can help with sleep, and that doesn't usually have any psych effects.  He agreed that there are a lot of typical psych meds (like ones mentioned here) that also have headache reduction benefits, but he wanted to try to stay out of that territory for now because he didn't want to contribute to any confusion around what's helping those issues and what's not...so that if I end up in a situation where I'm pulled off, for example, it's not the same sort of risk of causing depression as getting pulled off a TCA like with the doxepin.

I appreciate that he gathered the info on what's going on and took the time to explain his reasoning--like he always does, to be honest.  And it makes sense to do something in the prevention world simply because of how frequently I'm getting them, even if they're much lower on the pain scale, at least in my opinion.  Fingers crossed that it helps.  And fingers crossed for no itching.  I asked if it tends to have a 24 hour effect since I'd be taking it at night and he said usually, though he has had people have to take it three times per day...he doesn't think that'll be me, but we'll have to find out.

Thanks to all the others for the ideas!

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13 minutes ago, dancesintherain said:

My neurologist's thought was that because of the location of the headaches (back of head extending to sides slightly, with some neck tensions and stiffness seemingly related; front of my forehead),

My cousin found a muscle in her neck that she thinks is THE source of her migraines.

Of course I don't remember the name and of course I have to run out but it sounds somehting like:
sigmoid.......

I'll find out. There are massages specifically for the neck that you can get.  

Yay for finding a med!!!

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Thanks!  Yeah, it really doesn't seem like that far a stretch since right now I'd say they're tension headaches and not migraines.  Plus my neck and upper back are always where I carry stress, but they get particularly worse as I end up getting headaches (or the reverse of that).  When I was in the ER for unrelated issues, I got a shot of toradol and all of a sudden I could move my neck again without anything hurting...and then I had no headaches whatsoever for a good week after (prior to that had been 1-2 per day).  So I'm cautiously optimistic that this will help.

Also exploring getting a massage focused on the neck/back/scalp stuff for migraine/headache relief.  A massage therapist friend says such a thing exists, but that you need to make sure to go to the right kind of person and not just a big chain store.  There's also reportedly some sort of neck massaging machine you can get online?  Back when I was dating L, she had a trigger point thing that she could do at the base of my neck and I got relief within a minute or two.  Sadly, I don't still have her hand for that technique. 

I'm glad it worked for your cousin!

Edited by dancesintherain
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  • 4 weeks later...
On 7/6/2016 at 8:55 AM, water said:

My cousin found a muscle in her neck that she thinks is THE source of her migraines.

Of course I don't remember the name and of course I have to run out but it sounds somehting like:
sigmoid.......

I'll find out. There are massages specifically for the neck that you can get.  

water ... do you remember the name of the muscle or can you guide me in the right direction to finding the answer?

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"Sternocleidomastoid muscle. But the Trigeminal nerve is my culprit. Trigeminal nerve is where the serotonin receptor that starts the migraine cascade. "

I asked about fluid in her sinuses because we both suffer similar yet very different migraines. This is what she said:

"Fluid? Not fluid. Inflammatory response - still not totally understood the precise relation btwn nerve and vascular but possible inflamed nerves impinging with vascular. "

Cuz  migraines have been so bad she has spent the last year basically sleeping in a chair sitting up. So I asked her… Don't you sleep sitting up partially to keep your head draining?

"Sinus draining? Or to stop the nerve from over firing from being or pressed on. All seems connected."

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