Migraine.com Patient Perspective – Kratom
The kratom plant has received enormous attention over the last few months, primarily because the U.S. DEA proposed a Sept. 30 ban that would reclassify the previously legal herb as a Schedule One drug. Used medicinally by tens of thousands of U.S. citizens, the herbal supplement is said to help with chronic pain, depression, anxiety, migraines, and other ailments. Recently, Migraine.com community member and writer Katie Golden agreed to share with me her experiences using kratom to treat migraine.
SH: How old where you when your migraine attacks started?
SH: How often do you currently get them and how long do they last?
KG: Currently I have some degree of migraine every day. On a good day, the pain averages 4-6 on the pain scale and then at night it tends to spike up to an 8 or 9. I go through weeks of having more manageable migraine attacks and then I can go through weeks of barely getting out of bed. I am not able to work anymore due to the severe and debilitating effects.
SH: What other treatments have you tried? Did they help you?
KG: I’ve tried many other treatments, including triptans, preventives, DHE, opioids, Botox, PT, yoga and acupuncture, with some success (see below). I’ve not had any kind of surgery for my condition. I considered a neuro-stimulator, but found that I was not a good candidate. At this time, it [surgery] is not something I am pursuing.
- Triptans: I was a young teen when triptans came to market. Imitrex, Maxalt, Frova, Amerge. I’ve tried them all. When the migraine attacks were episodic they were the best thing that helped me. Triptans helped me sleep through the pain, but it would still take two or three days to get over the migraine.
- Preventatives: I’ve been on antidepressants such as Zoloft, Wellbutrin, and currently Effexor. I’ve been on beta-blockers like Inderal. Also tried Depakote, an anticonvulsant. Amitriptyline, an antidepressant, has been a mainstay for me since I was a kid. Topamax was helpful for years until I developed some serious side effects. I’ve used calcium channel blockers like Verapamil. Over-the-counter drugs like butterbur, feverfew, and magnesium have also helped me.
- DHE: Once triptans stopped working for me, DHE became my go-to for aborting an attack. Like any abortive, it’s not recommended to take it every day due to the risk of medication overuse headache (MOH). I limit my intake to three per week, however there is a DHE shortage, so I rarely feel like I have enough in stock to use that many a week. For me, the positive effects of DHE don’t usually show up until the next day, and it makes me very nauseous. When the migraines seem to be intractable, I often take injections of Toradol, an anti-inflammatory, along with the DHE to get the best results.
- Opioids: I have been using Percocet on and off for about five years. I am extremely cautious about using it. I’m well aware of the risk of MOH and the potential for addiction. When used properly, it can really help chronic pain patients. It tends to be a last resort for me to avoid the emergency room.
- Botox: I’ve been on Botox for five years. I find that it helps tremendously. It has a life cycle, so during the 12 weeks between injections I experience the most relief for 4–6 weeks in the middle. It never gives me full relief, but I am much more functional during those weeks.
- Physical Therapy: My neck and shoulder muscles are in a constant state of tension. I’ve had massage therapists say my muscles are like steel cables. I’ve done physical therapy three different times over the years. I always found it helpful during the actual sessions, but could never get a long-term fix using PT.
- Yoga: Yoga has been extremely helpful in working out the kinks in my neck and shoulders. Whenever I feel stiff, I stretch it out. I try to practice at least three times a week. It has made me feel stronger and more in touch with what my body’s needs.
- Acupuncture: I tried acupuncture years ago, before the migraines became chronic. Instead of providing relief, it actually triggered multiple migraines during treatments. I would be open to trying it again.
SH: How did you hear about kratom? How long ago was that?
KG: About three months ago, I heard about kratom from a friend and was surprised I’d never heard of it before. I also follow the chronic pain community, and I’d never run across it.
SH: What research did you do before trying it?
SH: Tell me how you decided which strains to try.
KG: There are red, white and green strains and then different variations within each category. I decided if I was going to try it, I would buy small samples of different types. I prefer the white strain because it provide energy AND pain relief, while others may make you tired. I’m always tired, so I needed something that would give me a boost.
SH: Where or how did you purchase it?
KG: I had read that many medical marijuana shops carry kratom, so I called around to many stores. Most had no clue what I was talking about. So I went back to the Internet and read reviews on different distributors. I found one that offered a variety of strains and had high reviews of the product, so I buy from an online source.
SH: How do you prefer to ingest kratom?
KG: I use powder most often. It doesn’t dissolve well in water so I just put it on my tongue and swish it around with water to digest it. I do it multiple times and in small doses until I take the full amount I need. I find that capsules aren’t as effective or I have to take more than I want to. I’ve also found a tincture that almost acts like an energy drink. It doesn’t taste very good, but it works.
SH: What dose do you use?
KG: I began using small doses just to see how it would affect me. I have a high tolerance after years of using medications. Through trial and error, I’ve found that a full tablespoon is effective. There are some highly concentrated strains, which I use at a much smaller dose.
SH: After consuming kratom, how long does it take for you to feel any effects or relief?
KG: It takes maybe 20-30 minutes to feel relief.
SH: Describe the feeling when it starts to kick in.
KG: I notice my pain level decrease. Sometimes it does have a similar feeling of being on an opioid. If I take an opioid, my nose starts to itch and kratom can do the same. One positive about kratom is that you can modify the dose you take. I don’t want that high feeling, so I’ve adjusted the amount I take.
SH: How did it affect your migraine while you were using kratom?
KG: I have chronic migraine and always have some level of headache pain. When kratom kicks in, my pain level decreases. For me, the pain never goes away completely (no matter what drug I take), but it can knock my pain level down a few notches.
SH: When the effects of kratom wear off, does your pain level change? How?
KG: Kratom probably works for about 4 hours for me. When it wears off my pain level increases, sometimes to the same level or it can only increase slightly.
SH: Are you currently taking kratom?
KG: I am currently using kratom. Thankfully the ban was halted to allow for public input. It’s been a three-month experimentation process for me, and I plan on continuing unless the ban is instated.
SH: Would you suggest others in chronic pain to try it?
KG: I would recommend that anyone thinking about trying kratom should do so now. However, do the research for yourself to decide if it’s right for you.
SH: Any other input you want to share?
KG: It won’t cure your migraine (as there is no cure), but kratom can provide some temporary relief. I find that it can give me a little boost, allowing me to be more productive. My overall pain management approach is to rotate different pain relieving medications, while trying not to rely on any of them on a daily basis. Kratom could be another tool in your toolkit.