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SSRI and menstrual migraine

Hi all! I have a big problem since a have severe migraine attacks of four days when I have my period en can’t take anything else then paracetamol since my neurologist doesn’t want to give me a triptan because of possible serotonine syndrome. Does anyone has some advice what to do or what to take?? What do you take for serious menstrual migraine. I feel desperate. Kind regards Manon from the Netherlands. 45 years old.

  1. Hi there- Thank you so much for reaching out about this. I hadn't heard of serotonin syndrome before so just did some research on it. It doesn't appear there is a way to diagnose it for certain and also it appears to be potentially short-lived in nature in that it can be resolved. I would hope this is the case so that you can eventually take triptans. Have you found triptans to be helpful in the past? Regardless, there are plenty of other kinds of rescue and preventative medications out there these days. Primarily, I would urge you to look into the CGRP class of treatments - a new approach to migraine treatment- they are available in rescue and prevention form. https://migraine.com/cgrp-new-direction-migraine-treatment
    Another thought is to perhaps explore the idea of taking a continuous low-dose birth control pill. Menstrual migraine is one of my worst migraine triggers and I have been prescribed continuous birth control in order to regulate my hormones. It really helps me.
    Finally, here's a link to our interactive page on current available treatments for you to take a look at in order to familiarize you with all that's out there currently: https://migraine.com/treatment-options
    Hope this helps you. Please let us know if you have additional questions or need for support. Warmly- Holly -migraine.com team.

    1. Dear miss Harding, thank you so much for your reply and help. Only CGRP agonists that can prevent migraine are approved in the Netherlands/Europe and besides that i have to pay it by myself when I want to try the preventive ones: 500 euros each month. 🙁. I am trying the mini pil/desogestrel since seven weeks but it doesn’t help. I still ovulate and migraines are even worse. Do you want to tell me what anticonception pill you are using please? One time I tried a triptan in the middle of a severe migraine attack and it didn’t help then. I really want to try the cgrp medicines for acute migraine but don’t know how to get these here in the Netherlands since they aren’t approved here yet. Thank you again in advance for your reply. Warm greetings Manon

      1. HI there- I'm so sorry to hear of the difficulties and limitations in accessing the medications you need or would like to even try. The pill that works for me (and of course there are so many out there) is one called microgestin fe 1/20. It is taken continuously to control the hormone levels and is a low dose estrogen pill. I know that taking/experimenting with these pills can sometimes cause hormonal migraines to flare. I really feel for you. There are other methods available to curtail hormonal shifts like the IUD. All these types of options may be worth discussing with your doctor. I hope the CGRPs will become accessible/affordable to you soon. We are here for you- thinking of you- Holly (migraine.com team).

    2. Hi ~ I am sorry to hear you are having these hormonal problems. Hormones can definitely affect our migraine disease. I am in the U.S., and I've never had a neurologist warn me of serotonin syndrome while taking a triptan. I don't have any suggestions or advice. I just wanted to express my support.
      Take care,
      Peggy (Migraine.com team)

      1. Dear Peggy, thank you very much. I read my first post again and now I see I forgot to mention that because I am on Paxil my neurologist doesn’t want to give me triptans because of the possible serotonine syndrome. Sorry I forget to mention that. Take care.

        1. I thought you might be interested in reading one of the articles of our contributors on the challenges of treating menstrual migraine: https://migraine.com/living-migraine/trickiness-treating-menstrual-triggered-attack. Thinking of you- Holly (migraine.com team).

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