Migraine Infusions: Be Prepared for Possible Side Effects

In June, I underwent three days of outpatient infusions to break the migraine cycle I was in. In a modified version of what’s known as the Raskin protocol, I received DHE, Zofran, Benedryl, and steroids by IV for several hours each day. I felt better for the three days of treatment. Then my world turned upside down.

About 30 hours after the last treatment, I became irrationally sad. I was in the early stages of a migraine attack, so I assumed that was the culprit, though my mood was much worse than usual. The migraine symptoms and bad mood lasted less than an hour. I got on with my day. The same thing happened mid-day, but my mood was even worse than the first time. I was bereft, worried that my migraine severity and frequency would never again diminish. The third time this migraine and mood flare happened, I was inconsolable.

I felt like my life was ending. Not that I was dying, but that the migraine attacks were going to once again swallow me up and that I’d lose all ability to function. Sobbing and terrified, I was as heartbroken as if someone dear to me had died. I knew my grief was probably the migraine attack talking, but the immense fear remained. My husband found me crumpled on the bedroom floor, wailing. He once again reminded me that I could get through this and held me until I fell into sleep, utterly exhausted.

I awoke the next day scared, but no longer frantic. I could step back far enough to see that migraine was not overtaking my life. My mood stabilized for the most part, though I was extra irritable for a few more days.

After I wrote about this on my blog, a friend who has chronic migraine texted to say she’d had a similar treatment a year ago. She also experienced overwhelming fear and hopelessness about a day after the treatment ended. It was a light bulb moment—maybe the steroids were the culprit. Some reading about steroid withdrawal told me my hypothesis was probably correct. My doctor confirmed this when I saw him a couple weeks later.

Think of this as a cautionary tale, not a warning to avoid IV therapy. Variations on the Raskin protocol bring relief to many people in status migranosis and it's a useful treatment. I share my story so you can be prepared for this potential side effect. Knowing what I was getting into would have gone a long way toward soothing my grief. If the mood changes are a serious concern for you, perhaps because of existing depression, ask your doctor if you can get the treatment sans steroids or if you can taper off them slowly. I don't want anyone to feel like I did that horrific day.

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