Medication Triggers in Autoimmune Migraineurs

Autoimmunity has been estimated to be the second leading cause of illness. Migraine is very common in those of us with autoimmunity. So are other headache disorders. There are many reasons why this is the case. One of them is triggers that relate particularly to those undergoing treatment for their autoimmunity.

What is autoimmunity? Autoimmunity is a disorder of the immune system that results in the body targeting and destroying healthy cells (self) instead of invaders like bacteria and viruses. Some common examples of autoimmune diseases are :

  • Lupus (antibodies attack connective tissues)
  • Sjogren’s Syndrome (antibodies attack exocrine glands)
  • Rheumatoid Arthritis (antibodies attack the joints)
  • Hashimoto’s Thyroiditis (antibodies attack the thyroid)
  • Graves’ Disease (antibodies stimulate TSH receptors in the thyroid)

Sometimes treatment of the underlying autoimmune disease will help the patient’s headaches or Migraine attacks. Unfortunately, it doesn’t always work that easily though. Sometimes the treatment medications themselves can trigger Migraine and other headaches. These medicines are often chemotherapy drugs and can include:

** Azathioprine (Azasan, Imuran) — triggers from this drug can include anemia, nausea resulting in eating changes, malabsorption and vitamin/mineral deficiencies

** Benlysta (Belimumab) – Headache (Migraine) is listed as one of the most common side effects of this newly approved lupus medication.

** Cyclophosphamide (Cytoxan) — triggers can include anemia, nausea and diarrhea which results in eating changes, malabsorption and vitamin/mineral depletion. Migraineurs are often deficient in Magnesium. Patients who are magnesiuim deficient may have particular trouble with other adverse reactions with this medication

** Cyclosporin — triggers can include depleted magnesium levels, vomiting resulting in altered eating patterns, malabsorption and vitamin/mineral depletion.

** IVIG infusions are strongly linked to Migraine attacks which can be severe, intractable and last for several days. A very slow rate of infusion and pre-treatment with IV Benadryl and oral acetaminophen or other pain medication is sometimes helpful. IVIG treatment can cause inflammation which itself can act as a Migraine trigger. Aseptic meningitis incidence is higher in Migraineurs using this treatment.

** Methotrexate — triggers can include magnesium depletion, and a depletion of folic acid levels. Methotrexate can sometimes increase to toxic levels causing symptoms like hyperosmia (increased sensitivity to smell) that may act as a Migraine trigger.

** NSAIDs, Opiates and other pain medications which may be necessary if the autoimmune condition is severe. This is a frequent cause of Migraine rebound/ Medication Overuse Headache (MOH) in autoimmune patients. The result is a no-win situation in which the patient’s daily and sometimes very severe pain is often left untreated.

** Plaquenil — triggers from this medicine can include neurological problems, problems with eyesight, increased photosensitivity, anemia, nausea leading to eating changes.

Note: Treatment with steroids can be very beneficial for both Migraineurs and autoimmune patients in the short run, but the side effect profile risk of long term usage sadly often outweighs those benefits.

More information can be found here: Migraine Triggers for the Autoimmune Patient

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (20)
  • Elaine Gross
    7 years ago

    I’m sorry to hear about the negatives regarding Plaquenil. It has been a miracle drug for me with the pain from RA. I only recently found out that this was a drug used to treat malaria, and that it can cause problems with eyesight. Not happy to hear that either, especially since my eyesight is pretty bad. Also I didn’t know about the increased photosensitivity and nausea – also already problematic migraine symptoms. Oh well, I guess you have to take the good with the bad, weigh out which is worse, and what’s more important and tolerable.

  • Donna Swabey
    7 years ago

    Wow, thank you! I was on Methotrexate for my rheumatoid arthritis and it gave me the worst migraines I’ve ever had, leading to hospitalisation. My rheumatologist and the local migraine clinic were unaware of any potential links. I shall print this article and take it to my upcoming appointments. Thank you so much.

  • David Vilson
    7 years ago

    Opiates are narcotic drugs that are derived from the opium poppy plant. As such, they are pain relievers and they tend to have a calming effect on their users. Prolonged use, or a wrong dosage, however, can lead to a dependence on the drugs, which is where the problems start.
    http://opiateaddictionfacts.com/opiate-addiction-treatment/

  • Teri Robert
    7 years ago

    And this relates to the original post how?

  • Lynne Lee Bennett-Cassaro
    7 years ago

    Wow…I am fighting a plethora of autoimmune (AI) problems. Didn’t link those with my. Mixed “permaheadache”…6 years, now. I cannot tolerate most meds…didn’t link that with AI, either. And, due to CVIDS I do take 30gms IVIG monthly. I was on sulfasalazine when 1st starting the IVIG and suffered what I still believe was aseptic meningitis…thank goodness I stopped the sulfasalazine instead of the Gamunex. I still get a worse H/A after the infusion but no BP spike, chills/sweating or writhing/screaming suicide H/A. I had Grave’s @ 15y/o, Juvenile RA@18, and have nonspecific autoimmune colitis, Adrenal Insufficiency, allergies with 3 shots every 10 days, an uncertain form inflammatory arthritis even attacking my throat which especially sucks since I live to sing!), Rosacea, and Rheumy suspects Sjogren’s/Behcet’s/Lupus/RA but DX is complicated by my primary immune deficiency….and those are just my AI DX’s. I keep telling e1 I have a lead deficiency(:
    Good article…thanks.

  • Diane Miranda Weaver
    7 years ago

    What makes me mad is the ONLY medicine that worked for me was MIDRIN, and it has very little if any side affects and they stopped making it, even though its been prescribed since the 50’s because the fda got involved and wanted millions of dollars of testing! and its a very cheap drug to buy, and the drug companys could not make enough money…I can take 2 midrin and I’m pain free in less than 45 minutes normally and never any side affects! I hate big drug companys and the fda! They only care about making profit and don’t care about us! wish everyone the best of luck..and love and peace! xo

  • Teri Robert
    7 years ago

    Sheli Thomas, your doctor can write you a prescription for the ingredients in Midrin, and you can take it to a compounding pharmacy. They can make a Midrin equivalent medication for you. I know quite a few people who are doing that.

  • Teri Robert
    7 years ago

    Diane, your doctor can write you a prescription for the ingredients in Midrin, and you can take it to a compounding pharmacy. They can make a Midrin equivalent medication for you. I know quite a few people who are doing that.

  • Sheli Thomas
    7 years ago

    Midrin worked really well for me too if/when I would have an aura or any other warning sign, and they didn’t knock me out like the triptans do. I really miss it.

  • Helen Williams Lopez
    7 years ago

    I have been diagnosed with several auto-immune diseases – Sarcoidosis, Sjogren’s, Hashimoto’s Thyroiditis, and Hodgkin’s Disease. I actaully had a research Immunoligist take my blood several times to study my immune cells – seems that my T-Cells suck! I did not realize auto-immune diseases also had a lconnection to migraines. I learn so much from this site! FYI my Mom passed away from Schleradema – a really bad auto-immune disease. Makes me wonder about the genetic connection.

  • Migraine.com
    8 years ago

    We’ve had several questions from migraineurs who also suffer from autoimmune diseases (lupus, RA, etc). Ellen – Thanks for sharing such a great article with us!

  • La Diosa
    7 years ago

    Marie LaBarr Derby Just to let u know that all the medications they gave me like u didnt work… It was only when I went completely VEGAN did the headaches stop. The reason was the dairy in the pills and the egg.. so before I found that it was the dairy I suffered like no other and they couldnt figure out what was wrong with me.. I tell u it was the best thing I ever did and rarely get them now only if i get cross contamination with something that has dairy in it.. U should try that b4 doing anything drastic like what they want to do to you…. give it two weeks no dairy or eggs and see what happens u can still eat meat if u want to but I didnt want to and wow what a difference in three days it made for me….

  • Lynne Lee Bennett-Cassaro
    7 years ago

    @Marie LaBarr Derby… I did the Medtronic Spinal Cord Stimulator surgical trial this year for chronic right sided stabbing&burning pain DX’d as PHN or shingles nerve damage. I think it helped but the md only did it for such a small area since it is not helpful for arthritis but he discovered Congenital Spinal Stenosis so I have to have another trial. And, it will take a second trial and future implant for my headache. If your pain is localized to the back or occiput they only have to put leads there. I need leads to almost whole head. Leads can migrate, there is risk of infection. But it can be life changing. You can speak to Patient Ambassadors who have undergone surgery. Also ask your device rep on the side if he or she would have your neurosurgeon perform the surgery on their own mom…you do t want some hack doing it.

  • Ellen Schnakenberg
    8 years ago

    Deborah, I’m wondering about your diagnosis of cluster Migraines. There are Cluster Headaches, and there are Migraines, but there is not actually a diagnosis of cluster Migraines. Cluster headaches are actually a different disorder altogether, with a different type of treatment. Migraines that seem to come clustered together often have a trigger that hasn’t yet been recognized causing so many attacks to be set off. One attack can also rebound over and over depending on medications taken. You can see that it can be very important to get to a doctor who can give you an appropriate diagnosis for your problem since appropriate treatment is based on that diagnosis. A headache specialist is the best bet for most of us who are complicated cases, as these are neurologists who have received specialized training to diagnose and treat headache disorders.

  • Raven Monk
    8 years ago

    Imitrex is the other drug I cannot take due to blood vessel spams which could bring about a stroke. I have tried Topamax, with no help. I have heard great things about DHE, but the bad thing is it is IV only, so you cannot take it at home. I had it in the hospital, and it was heaven. Check it out!

  • Raven Monk
    8 years ago

    I hate migraines, I have them since I was 34. I take Fioricet with codeine and Percocet. 7.5/325 Because my migraines are due to blood vessel spams, I cannot take Maxalt, or any of those type of drugs. Migraines control my life, and all that help are a dark room, a bed, and drugs. I am literally down for the count for 2 days straight at times. I have had two mini strokes so far. I have a great Neurologist.

  • Deborah Butler
    8 years ago

    I suffer from Cluster migraines. The worst pain ever!!!!! Maxalt does NOT work, Florinal works for two days then NOTHING. Luckly I only get them every 3 months, but then for 25 to 30 days in row. HELP Me!

  • KarlaJo Jackson
    8 years ago

    I’ve heard of the procedure however, I’m not to that point, I’ve tried numerous oral medications and my neurologist suggested MAXALT. Uf I feel one coming on, I takke oone and because it melts it is absored into my body a lot faster and kills the headache before it csn knock me outm

  • Debbie Lopez-Bouley
    8 years ago

    I have had the implant done. Do you know where they will be placing the leads? To what nerves? It workings amazing, but I have still had to stay on some meds. I suffer fom chronic occipital neuritis as well. There is not an hour that goes by that I dont have a HA. I have had a cryo, injections…numerous meds. Sometimes you get to the point when I wonder if I am going to ever spend a day out of bed and out of the dark. Good luck Marie. Please let me know how it goes,

  • Marie LaBarr Derby
    8 years ago

    I suffer from daily chronic migraines – I have taken everything under the sun – I even did acupuncture, seen many neurologists and even seen a chiropractor – nothing works – I finally found a Great Neurologist – He put me on Percocet – and Its not working as it did before – I am supposed to be shortly having an electric stimulator implanted for a trial for 7-10 and if that works they will permanently implant.. Has anyone had this procedure done? My doctor highly recommends this and stated it very effective – But I may feel some relief but may take a while to take effect as I have been suffering with really bad migraines for about 4years

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