Missing a Dose of My SSRI Triggered a Migraine

I couldn't believe it, but I was having an aura. I hadn’t had a migraine in years, and now, on a random February morning, I was getting an aura. I thought I’d kicked this thing.

What did I do when the aura started?

I was about to drive my daughter to preschool, but I couldn’t see. I texted my husband, but he didn’t answer. I had the fog of the beginning of the migraine when I can’t think all that clearly and when I feel spacey and slow. I really didn’t know what to do and felt frozen with indecision.

I no longer had prescription migraine medication, but I took some ibuprofen. I called my daughter’s preschool, moving the phone around to avoid my aura, a black spot in the center of my vision that made it hard to see the phone screen. I excused her for the day. I turned on a movie for the kids and found a soft gel ice pack in the freezer. I closed myself in the guest room because it was adjacent to the TV room and turned off all the lights. I climbed into bed and put the ice pack behind my neck as the pounding pain began.

Why was I having a migraine attack?

Why was this happening? Why was I getting a migraine now? I thought through my list of triggers. I hadn’t eaten anything super processed or strange. I hadn’t looked at any flashing lights or weird patterns. I’d been home all day!

I remembered.

What triggered the attack?

I had forgotten to take my pill. I’d started taking an SSRI, Lexapro, a couple of months earlier. I had a hard adjustment to taking antidepressants for the first time in my life and spent the first week on the drug headachey, tired, sick to my stomach…which is how I felt now, but more acute. I dragged myself out of bed, checked on the kids, who were totally fine, and took my pill along with some acetaminophen to help with the worsening pain. My hands were numb. This was full-blown.

How did my husband help?

My husband did eventually see my message and reminded me he had a half-day and would be home at lunchtime. I asked if he could bring me a very large, black, iced coffee from my favorite place. It’s my favorite because, in their iced coffee, they use frozen coffee ice cubes. I lived until midday and gratefully accepted the coffee. I chugged half of it and waited for the ice cubes to melt. I hadn’t eaten anything since breakfast but had no intention of adding food to the fire happening in my body and brain.

How did I get through my appointment?

We had an appointment with our family therapist that afternoon, and my in-laws came over to watch the kids. I looked like a celebrity in the fluorescent lights of the waiting room, wearing my sunglasses inside and nursing a giant iced coffee. The therapist turned off the lights in her office and spoke in a soft voice when I told her why I was rocking the Blues Brothers look.

How did I feel at the end of the day?

By the end of this very long day, I was feeling better but a bit like a giant bruise with a postdrome. Not only was this my first migraine in years, but it was also my first undermedicated migraine in nearly a decade.

What did my doctor do?

I made an appointment to see my primary care doctor and asked for the fastest-acting delivery method they had, telling her I was terrified of getting stuck somewhere with my kids and not being able to drive them home. She prescribed me a nose spray that looked like allergy medication. She said it worked faster than the dissolvable medications I’d been given previously.

While I was curious to see if this new way of taking medication would work well for me, I was fortunate enough to get another break from migraines after that, and the medication expired before I could use it. I’m thankful that everyone was safe when this unexpected attack downed me on a busy weekday, but I’m thankful that I have a plan in case it happens again.