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ADHD Medications and Migraines

I am wondering about the use of ADHD medications, specifically Adderall XR and it's potential impact on chronic migraines. I have had migraines since I was 11, and they became chronic about two years ago. I have tried Topamax and Nortriptyline but both had awful side effects that I could not tolerate. Topamax made me feel as though I was constantly experiencing low blood sugar (to the point of almost passing out), and I could not stay awake on the minimum dose of Nortriptyline. I also have idiopathic hypersomnolence (not quite narcolepsy, but I have a lot of trouble staying awake during normal tasks, such as driving). My new insurance company does not cover Provigil (Modofinil), which is the standard treatment, so I am trying Adderall XR. I am awake and able to function, but am worried about the fact that headache is listed as a possible side effect. I noticed on another page here at Migraine.com about preventive medications that it is actually considered a potential preventive medication for migraines:

"medications originally developed for attention deficit hyperactivity disorder (ADHD), including dextroamphetamine (Adderal), and atomoxetine HCL (Strattera)." https://migraine.com/blog/migraine-management-essential-4-preventive-treatment/

Has anyone else had any experience with this? Did it help the migraines or make them worse? I absolutely have to take something to keep me awake, but certainly don't want to be in constant pain either.

Thank you so much for any advice or insight.

Denise

  1. Hi Denise,

    I've not tried Adderall, but know patients who have. Hopefully they will be in shortly to share their experience with you.

    Headache is listed as a potential side effect on many medications, but that doesn't mean everyone who takes it will experience a headache or any side effects at all. It's good to educate ourselves about potential side effects and easy to get caught up in worrying about them. When I start new medications I try not to pay attention to potential side effects unless I encounter a problem. I do however read about contraindications to make sure the new medication does not interact with the other conditions I have. Does that make sense?

    Let us know how you make out with Adderall if you decide to take it,

    Nancy

    1. Hi Nancy,

      Thank you for your reply. After two weeks, I'm happy to report that I have only had one migraine, and that was a day that I did not take the Adderall. I have had some pretty awful caffeine withdrawal headaches, but they are very different from the migraines that I usually get. I have been able to prevent them by drinking a small amount of coffee. So all in all, it has been a positive experience.

      Denise

      1. Hi Denise,

        I am on a low dose of Adderall not as a headache preventative actually, but for ADHD, which I have along with migraine headaches. I do notice it helps with migraines a bit though, there are days I wake up with a milder migraine that it goes away when I take my morning medication, so that is handy. One thing to be careful of though is that regular (is that even a term?) headaches can be a side effect of Adderall, and for me sometimes that low grade both sides of the head throb can turn into a pounding migraine if I leave it be for too long. Here's some tricks I use with the Adderall to avoid that.

        1) Stay hydrated. Always important, but Adderall can add to the need.

        2) Eat! Stimulants will make you feel like you aren't hungry, but if blood sugar drops are a migraine trigger for you, eat anyway. Even if its a little something, stay on your meal schedule.

        3) Pay attention to your body/muscle tension. Sometimes the focus that the stimulant medication can help with for attention can become a hyperfocus, and the world is tuned out for a task at hand. For me sometimes, this means tensing up my shoulders unconsciously while I am typing something up, or similar lack of attention to muscle and position. Take time to check in with your body.

        All of these are handy for regular migraine prevention anyway I've found, but on the stimulant medication become extra important check-ins. Glad this is working for you!

        -Rachel

        1. Hi Rachel,

          Thank you for sharing your experience, I really appreciate it. I too have noticed a lot of unconscious tensing of my shoulders while I work, and also grinding my teeth. The teeth grinding is not entirely new, as I've been doing that since I was a child. However, it was just a nighttime thing, never during the day. I now find myself sitting at my desk with my shoulders and teeth clenched tight. I will be sure to pay closer attention to this and remind myself to regularly step away from the computer and relax (that's probably good advice no matter what!).

          I agree that hydration is so important. Getting dehydrated is definitely a migraine trigger, so I tend to drink a lot of water throughout the day. I have found that the Adderall makes me very thirsty. And I've had to watch the food too. I had a really busy day at work a few days ago and never ate lunch. The lack of a feeling of hunger made it really easy to just work all day without stopping for food, but that can definitely set off a migraine.

          Overall, I feel like the Adderall is doing a good job of keeping me awake, and now that the caffeine withdrawal headaches seem to have subsided, I am feeling better.

          Thanks again for sharing!

          Denise

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