Migraine treatment

kubs_24 · August 2014

I have suffered with migraines for most of my adult life. Pregnancy has made my headaches more frequent and intense. My OB referred me to a neurologist to establish care and determine if there were treatments/meds that he would recommend for remainder of pregnancy, then after pregnancy. My OB has allowed me to take fioricet (sparingly) with this pregnancy and last pregnancy. The neurologist today said stop taking fioricet and prescribed imitrex 50mg and suggested a magnesium supplement for remainder of pregnancy. I really thought imitrex was a big no-no during pregnancy but he assured me it was fine. Pharmacist said there is limited studies. I didn't fill prescription yet and plan to discuss this with my OB at next appointment (Thursday). Does anyone have feedback from their doctors that they would like to share?

tinkerbell1658 · August 2014

Im the same with history of migranes. I went to a specialist , she has me on 1000mg (2 normal extra strength pills) tylenol, 1 pill reglan ( forgot the mg), and a cup of coffee/caffiene as needed. Said up to 3000 mg of tylenol was safe. Kicks them right out for me!

kubs_24 · August 2014

When I took inventory of my Tylenol, I was somewhat alarmed by how many I've taken during this pregnancy. I take 2 Tylenol at least per headache (sometimes more), chase it with caffeine and I often still get no relief. I have been averaging about 1 migraine a week and he didn't seemed too concerned about using the imitrex only 4x a month. I'm thinking with only 10 weeks left, maybe I should put my big girl panties on and stick to Tylenol until I deliver.

hiketheworld · August 2014

I've been pretty lucky in that mine have gotten less frequent but what I've done is the second I feel like I could be getting one, I drink a cup of caffeinated coffee, then a bunch of water. I carry earplugs and sunglasses and shut out as much noise and light as I can. If I am home, I lay down and/or just go to bed. I'm not taking any medications including Tylenol during my pregnancy so I don't have advice about that. The worst it's been had be in bed for about 18 hours with a (non-migraine) headache for the next two days.

carcrashheart · August 2014

I've been on imitrex for both pregnancies (and obvs in between). The last OB cleared it and this one didn't even flinch when she saw it on the chart. Thank your stars your neuro is being so proactive, many won't treat pregnant women. You probably should have been seeing a neuro a long time ago. It was explained to me that imitrex went to a generic drug so quickly that the studies they were doing didn't have enough time to complete and now there's no money to do so, but that while it's classified as a level C med it should probably be a level B.

I get 15+ migraines/mo so chances are I'm taking a ton more of the med than most. DS is just fine.

I've learned from the neuros that caffeine should always be limited to 12oz or less a day since it can be a trigger. I've also learned from them that if Tylenol in high doses takes it away, even with caffeine, that it is a headache and not a migraine (there's a difference).

Magnesium supplements are always suggested, as well as riboflavin. Neither help me so I cut those extra pills out. Reglan gives me a fucked up reaction so I never take it. My RE gave me an RX for fioricet but my neuro told me not to take it because it can cause rebounds. The same with taking a lot of OTC meds for a headache (like Tylenol). Too much and you give yourself rebound headaches. So I generally stay away from Tylenol and Advil regardless.

I have always been treated with a daily preventative med plus a rescue med (imitrex) to take as needed. My preventatives have changed and obvs none have worked all that well. I'm currently on 75mg noritriptalyne (sp) and atenolol. Once I give birth I will try two rounds of Botox. I did one round after DS was born but it didn't help. However, I was on Zoloft and that was causing more headaches that I didn't figure out until later. I never bought in to the Botox treatment but my migraine frequency has gotten so excessive that I've become desperate to try anything. Right now I'm at about 2-4 migraines/wk, which is down from 4-7/wk. still not good though, but more tolerable.

When I was pregnant with DS I had a smaller allotment of imitrex pills but I also had the time to lay around in agony. Now I have an allotment of 15 pills/mo, which can be refilled every 25 days (and I show up at the pharmacy every 25th day so that is have back ups). Living with a toddler doesn't allow for me to be left alone in agony, so I have to take my meds in order to not become disabled with pain, which is what will happen if I don't take meds.

So, to sum up: imitrex is not bad. To the uninformed, it is. To the informed, it is not, especially if the alternative is an excessive amount of neurological stress on the mom and baby. But how much pain you're having will help you decide how to move forward.

lizgrace03 · August 2014

I think Imitrex, Fioricet, and Zomig are all class C drugs, so while some doctors seem to think the Fioricet is safer, I don't know why. I have taken Zomig twice during this pregnancy (both times during the first trimester) because Fioricet did nothing for me. My migraines have thankfully died down, but I think I would take the Imitrex if it's helping if I were you.

kbelle13 · August 2014

I know you have been getting migraines your whole life, and I am sure you have tried everything, but I figured I could still share what has been working for me. Imitrex used to be my go-to until I got pregnant. Since pregnancy, I have been "sorta" controlling mine with caffeine and going to the chiropractor 2-3 times a week. I still am getting migraines, but the number and severity has definitely diminished greatly with my visits to the chiropractor. Even with a migraine now, they are minor enough that I can function through the work day long enough to get home and sleep. I have also gone from about two migraines a week, to only two a month.

Again, as a fellow migraine sufferer, I understand you have probably already tried a chiropractor, but just in case you hadn't, I wanted to share what has been working for me. I had never been to the chiropractor since before the pregnancy, but now that I have been avoiding the drugs that have historically worked so well, I found the chiropractor to be of some relief.

carcrashheart · August 2014

I wish a chiro helped mine. I've seen three, all of which promised to help. Two of which admitted that they were stumped as to why it wasn't helping. Womp womp woooommmmppppp. Good try though. Not a cheap treatment. Then again, neither is Botox. I've only agreed to it because my deductible is met this year, just as it was last time I had it. The neuro thinks my insurance will cover it now and the means I can try back to back rounds, but no confirmation yet. Botox sucks. It hurts. I can't move my forehead and that pisses me off since I'm not a Hollywood socialite. But if it works........so be it.

Anyways, good luck figuring out what works for you! Pregnancy is definitely a game changer. Last time sleep didn't help my pain, which works while not pregnant.

abbyful · August 2014

Have you tried diet changes? I used to get frequent migraines. When I switched to eating a mostly paleo/primal diet, they have pretty much stopped, I've only had 2 in the last several years (and those were when I had started eating SAD again).

runningmama14 · August 2014

I've been so lucky that my migraines have gotten less frequent and less severe with pregnancy. I have been able to avoid taking any of my normal class c meds, but if I hadn't been so lucky, my doc and midwife were both fine with fioricet and imitrex if needed. My migraines also trigger tension headaches/muscle cramps that go down my entire side. Tylenol helps with that aspect, but doesn't actually help the migraine.

lizgrace03 · August 2014

abbyful said:
Have you tried diet changes? I used to get frequent migraines. When I switched to eating a mostly paleo/primal diet, they have pretty much stopped, I've only had 2 in the last several years (and those were when I had started eating SAD again).

This. For me it was the forced cutting out of Coke Zero due to the caffeine, and I've only had two migraines since first tri.

MamanJones · August 2014

I've been taking magnesium as my doctor suggested. But I did get a migraine today and spent about 3 hours in bed out of commission. Before the magnesium they were lasting all day.
I've been suspicious of certain foods, but I seriously believe that I am at the mercy of drastic changes in the weather/ atmosphere
Glad to hear I'm not alone!

ShelleyElla22 · August 2014

I was taking magnesium daily and got lidocaine shots in the back of my head. Those two things seemed to help mine.

tinkerbell1658 · August 2014

So many different things help everyone differently, its good to see all the options. I was diagonsed with migranes by a neuro when i was little, used to do a lot of different things. Imatrex worked the first time i took it then i got reactions so i cant take it now. Before i got pg i was on the fioricet i think, i cant remember which! Lol. But the combo i put above works now as long as i catch it early. I was trying no meds/caffiene but with a 4yr old being incompasatated isnt an option. Did it once and thankfully it was ok. Good luck finding the right combo for you!

Eta.....the tylenol alone didnt work, it wasnt until i added the reglan and was proactive (didnt wait) that it worked.

I also saw a neuro that specializes in pregnancy. And definately migranes no matter what meds work.

Colleen12589 · August 2014

I have had migraines since I was a kid, tried a bunch of different meds. Ended up being inpatient for a week at the diamond headache clinic in chicago. Pretty much at that point I stopped treating my migraines. I know it sounds counterproductive but for me that has been the trick.

I now have so many fewer migraines and headaches (more in pregnancy but still way less) and when I do treat them Tylenol and a cup of coffee or excedrin migraine when not pregnant work for me. I literally used to laugh at people when they said that those meds got rid of headaches thinking that they didn't know what a real migraine was then.

It sucked for about a month not takin anythig for them but after that got better. I also think my inpatient stay helped get them under contol. They use some IV drug that puts a stop to the cycle. I can't remember what though. I also did some biofeedback lessons that helped a lot, learning how to draw blood flow away from my head and to my hands and feet. Good luck! Migraines suck hopefully they get easier for you.

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