February 6, 2014
I am allergic to TRIPTANS, as they make my throat tighten. I was told not to take them. I have tried the beta blockers, one called keppra, topmax, and countless others. At one time the army doctors had me on so much medication I was taking like 15 to 20 pills a day and I didn't even know myself anymore. I was having monster panic attacks, depression and trouble in my marriage. So my question is this do any of my fellow migraine suffers know of anything that might help? I use to only get relief from prescription pain medication, however I am now living in Kuwait and they only want to give Tylenol. Please if there is something you think might work I would like to know. Have children and tired of not being the best mom I can. Thanks,
February 9, 2014
You're actually dealing with a fairly common problem.
The first thing to realize is that triptans are an abortive medication. They stop the Migraine process. The pain relievers like Tylenol are pain killers only. They cover up the Migraine process, which is why they often don't work, and in fact can actually cause additional problems. Then there are the preventives like topiramate. They work over a period of time to help prevent the number of attacks and/or the severity of attacks.
As to the Triptans, I wrote an article recently that addressed this. I too am unable to take them, so it's definitely an interesting subject to me. Here's a link to look at: Treating Migraine without Triptans or Ergotamines https://migraine.com/blog/treating-migraine-without-triptans-or-ergotamines/ As to whether or not you're having a true allergy, only your doctor can tell that for sure, but there are a lot of potential side effects to triptans that can be scary, but not dangerous. Additionally, there are many triptans, and they are absolutely different from each other. The worst side effect profile tends to come from sumatriptan, but many of the others are very different the others. Some work fast. Others for a long period of time. There are different properties for each. A true Migraine and headache specialist can be helpful figuring this out. You'll see in the article there are plenty of other options though.
As to preventives, it takes several weeks or months to try a single preventive. There are enough of them available that it would actually take 25 years to try them all! The trick is having the patience to start low in dosage, going up slowly and staying at the most effective dosage long enough that you've given it a chance to help you. This can take 6 months for a single med. It's a terrible thing to mistakenly discard a drug that might have been helpful, but wasn't because it was not taken properly. Often preventives work best when added together, or even added to alternatives like CoQ10 and Riboflavin etc. This business of having Migraine will likely be one of the toughest trials you'll have, but there are so many options that there are no reasons to give up and assume that all preventives are going to make you feel the same way. Here is a link to our forum where you can look at some threads for specific meds that may help you understand them a little better. It's also a good place to go for information from patients who are actually using them. https://migraine.com/forums/
Pain relief. That's what we're all after, but pain killers are contraindicated in most Migraine situations because they just cover up the attack. What's worse, they can cause changes in the pain pathways of the brain resulting in Medication Overuse Headache (MOH) which means that you end up in daily pain that can be impossible to distinguish from Migraine. Here is a link on MOH that is helpful: https://migraine.com/blog/help-how-can-i-not-overuse-migraine-medications/ Tylenol and NSAIDS along with Fioricet and caffeine tend to be the most frequent causing these problems. Even triptans (an abortive) used too often can cause MOH though, so it's best to know the trouble makers for Migraine patients and use them 3 times or less per week as presscribed by a knowledgeable doctor. As far as using them, there are times when they're appropriate, but really attacking the Migraine itself and ending the process will end the pain anyway, so most doctors try to help you with that. If your doctor is telling you to use Tylenol, they're not likely very educated in Migraine and headache medicine, unless you're having very infrequent, mild Migraines. Due to the type and number of meds you've had to try, it doesn't sound like you're in that category though.
Feel free to read the articles, print them and their sourcing and give them to your doctor. Since you're in Kuwait it will be tougher to find an actual specialist, so you may be stuck educating the doctor you've already got. I'm so sorry. If your doctor is sensitive to your needs, hang in there and work with them. We have a ton of great information written by specialists, doctors, patients advocates and experienced patient bloggers that you can always reply with a question if you have one and we'll get you sources your doctor will pay attention to.
Please write back and let us know how you're doing and what you are able to do there. This is a US site, so working with patients elsewhere can be tricky. We will try though 😀