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Rx in same Class

How worthwhile is it to try multiple preventative drugs in the same class? I know for triptans it took 3 tries before I found one that helped - maxalt made me vomit, dizzy and vertigo for a few days, axert made me dizzy and extremely nausea for days without helping migraine. But imitrex finally worked - it the beginning it actually stopped all symptoms and just had a little lingering side effects.

I have tried both topomax and vaporic acid - neither helped. Would it be worth trying gabapentin?

I also have tried with no success - propranolol (dropped blood pressure too low), cymbalta, tramadol ER (does help a bit), amtripyline (going to have to come off soon - causing 3-4 pounds weight gain each week, I'm getting stretch marks on my thighs from the weight gain. And of course this one was starting to help the depression, just can't win!), candersartan (honestly don't know why the headache specialist put me on this one ...), Botox and medical cannabis.

Not sure which ones I can try now .... headache specialist (only one in Alberta) barely knows anything - I had to educate him about migraines. I do have a doc that has done the headache certificate that works as a pain management but he does Botox, nerve blocks, trigger point injections and you get 5-10 minutes max with him. Doing those twice a week does help but I need to bring down the number of migraines. He is awesome though when I come to him with ideas of different things I want to try (I saw nasal spray imitrex instead of pills and works MUCH better and has kept me out of ER numerous times. He also prescribed me injectable toradol that I can bring to his clinic for those decently painful migraines that suck but aren't bad enough to warrant urgent care.

Any ideas would be gratefully accepted!

  1. gabapentin helps me with the pain, but causes weight gain for me. I still take it, btw, but just so you're aware. I take it along with Topomax and Nortriptyline, and also do Botox. The only two I can be SURE work are the gabapentin and the Botox, but I'm a little afraid to come off the topomax.

    1. Hi Tamara,

      Thanks for your question. I would say yes, it's worthwhile to try different medications that are in the same class. Try not to lose hope, there are over 100 medications that can be used to treat migraine disease. And it may take a combination of medications to be effective in managing our migraine disease. Unless we give each medication a fair trial we'll never know which one would be the one to work. Unfortunately it can take up to 90 days before we see a reduction in our migraine frequency and severity when we start new medications. Does that make sense?

      I'm glad to hear your doctor is willing to try different things and work with you to manage migraine disease. I've also found triptan nasal sprays work MUCH better for me than pills.

      Let me know what you think,

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