Stop Telling Me I Have Medication Overuse Headache
Here's a confession many people with migraine won't make publicly: I took two Amerge (naratriptan) and four Midrin every day for 16 months. My headache specialist was aware that I was doing this. Although he prefers I not take acute medication so frequently, he recognized that it was the only way I could function. We monitored my symptoms closely and about a year into my increased frequency of medication use, he noted that my symptoms were worsening in a way that’s consistent with medication overuse headache (MOH). But he didn’t push me to stop the medication.
Being shamed by my new headache specialist
Then an insurance change required that I see a different headache specialist. She zeroed in on MOH immediately. She wouldn’t listen to my explanation and didn’t seem to believe that my other headache specialist was supervising my treatment. I felt blamed and shamed. I left the appointment frustrated and angry.
Of course I knew that taking acute meds as frequently as I did can lead to MOH. But what else was I supposed to do? I have a migraine attack every time I eat or drink anything other than water. I can’t not eat (though I have considered it).
Could acute migraine medication be making things worse?
Despite my anger and defensiveness, the “what ifs” began creeping in after I saw the new headache specialist. A ketogenic diet and the gammaCore, which I’d just begun using, were both somewhat effective. Yet both seemed to become less effective over time. What if I was losing ground with the treatments because I was sinking deeper and deeper into MOH? Would detoxing make the treatments more effective? Was my acute medication use making migraine harder to treat?
I couldn’t stand not knowing the answers to those questions. Since detoxing from my acute meds was the only way to get the information, I did it. Within two days, I noticed progress. After a week off the meds, the improvement was so remarkable that I danced around the kitchen with tears of joy streaming down my face. I felt free.
I had answers to my questions.
Detoxing helped my medication overuse headache
Yes, I lost ground with my other treatments because I was in MOH.
Yes, my treatments became more effective after detoxing from the acute meds.
Yes, my acute medication was making migraine harder to treat and, quite possibly, causing the preventives I tried to be ineffective.
Before I detoxed, I was sure that I didn’t have MOH. I was sure that I was using my medications responsibly. I was sure I would notice if I developed MOH. I was wrong on all three counts.
I was wrong, I am suceptible to MOH
I had medication overuse headache.
I thought I needed my acute meds. And I did, but only because my overuse made physically dependent on them.
My year of vehement denial that I had MOH left me more than a little embarrassed. Having fewer, less severe migraine attacks is such a reward that I’m able to swallow my pride and admit it: I am susceptible to MOH. I know because I developed it.
It's a good thing my doctors didn't stop telling me I have medication overuse headache.
Can you tell when a migraine attack is coming?