My Migraine Medication Journey

There are many medications that can be used to treat/prevent migraines. I have tried many since my actual migraine diagnosis. I say actual because I had symptoms for years (started around 1995), but, the military had not given me a diagnosis of migraine, until a hospitalization in 2005.

What medications did I take before I was diagnosed?

Being in the military, one of the first medications I was given was ibuprofen. We would jokingly say ibuprofen 800 mg, was the cure for anything you had. You were given anywhere from 10 to 30 pills, as a firstiline treatment. I was given this for headaches, backache, knee pain and all over body aches.

The next medication was etodolac, 400 mg. It is another non-steroidal anti-inflammatory drug (NSAID), like ibuprofen/Motrin, for pain. I was using this and acetaminophen for head and related pains. Another medication was to treat my nausea/vomiting. This was Phenergan 12.5 mg. It was given at the ER or “sick-call.” Sick-call was the military’s version of urgent care. One last medication was Tramadol, 25 mg. Tramadol was for severe pain not controlled by the others. I often tried not to use it. This was the last measure before the ER.

What medications was I given in the hospital?

I had gotten to the point where tests were inconclusive as to what was going on. There were some areas of concern on cat scan (CT scan), at the cerebellum. My head pain was at its worst. I could not walk straight. This was not just for a day, but went on for about two weeks. I was admitted, from the ER, for further workup and possible brain surgery.

After some testing, the final diagnosis was migraine with associated vertigo. This was almost twenty years ago. They trialed me on lots of medications during this ten-day period. Listed below are what was given to me:

• Atenolol 12.5 mg daily
• Zolmitriptan 2.5 2x daily
• Cyclobenzaprine 10 mg Q 12 hr
• Gabapentin 600 mg 2x daily
• Nalbuphine injection 10 mg at bedtime
• Odonsatron 4 mg every 8 hr
• Promethazine 25 mg injection every morning and bedtime
• Metoclopramide 10 mg every 8 hrs as needed
• Topiramate 300 mg at bedtime
• Visteril 25 mg 2x daily
• Prochlorperazine 5 mg every 6 hr

You might be saying, “that is a lot of medications!” I would agree with you. They had me so drugged up that I hardly remember anything from this hospitalization. I was semi-awake, most times. I think that was the goal. Wake or not, they would still do the injections for pain. They probably could have told me anything, and, I would have agreed. Haha. They were trying to get my migraines under control. Once they found things that were most helpful, we continued those when I was discharged. I am so glad that there were things that helped the symptoms.

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What were my treatments when I got home?

When I left the VA, I was given a few medications to start at home. I now had an official migraine diagnosis. Here is what I went home with:

• Zolmitriptan oral disintegrating tablet 2.5 mg as needed (PRN)
• Atenolol 12.5 mg daily
• Odonsetron 8 mg 3x daily PRN
• Hydroxyzine (Visteril) 25 mg 2x daily
• Prochlorperazine 5 mg every 6 hr
• Meclizine 25 mg 2x daily
• Topiramate 300 mg at bedtime
• Gabapentin 300 mg 3x daily

Some of these medications helped. I did not continue the hydroxyzine, meclizine, or prochlorperazine too long.

Were there any other changes to my treatment?

I stayed on zolmitriptan (Zomig) until the VA could not get the ODT version anymore. This medication had been very helpful. I did not want to try anything else, but had to. We switched to the nasal sumatriptan, 20 mg. This was a great change!

After being on topiramate and gabapentin for several years, we made changes to the doses when needed. We also added Elavil (amitryptyline) 50 mg daily. I no longer take any of those.

What is my current migraine regimen?

Today, for migraines, I use Aimovig 140 mg as a preventive medication. I was glad when the once monthly medication came about. This has been a good one for me. I still use odonsetron (Zofran) 8 mg, but the IV form, in my port. I use Zofran multiple times daily. I also use the nasal sumatriptan, 20 mg as needed when a migraine hits.

Everything is trial and error. When something works, keep it. Sometimes, change is good though. Not being able to get one of the medications, led to me getting something that was better. Hang in there if you are not to this point yet!!

What's your migraine medication journey like?