When Your Faithful Medications No Longer Work
If you’ve had migraine for awhile, chances are you’ve been through it.
In fact, anyone with a chronic condition can probably identify with what I’m about to say.
Some of my most reliable medications have stopped working, and some of my new protocols—backup plans, in effect—aren’t effective.
Like many migraineurs, Imitrex was the first triptan I ever tried. I will never forget the little shining gem of hope in my heart when I took my first tablet. It was the summer of 2001, a full eight years after I started getting migraines and a few days after I finally got diagnosed. After years of being dismissed by doctors (or—something that is just as heartbreaking—not bringing it up with doctors at all because I didn’t know I should), I’d finally gotten a correct diagnosis after spending less than five minutes with a new general practitioner.
I was at my parents’ house in Florida when yet another migraine attack came rolling in. This time, however, I had an actual prescription for Imitrex. I vividly recall lying on the couch in their sitting room right after popping a tablet and drinking a glass of water.
It was miraculous.
A rollercoaster of effectiveness
Years later, Imitrex stopped working for me. I wasn’t too bummed, because my doctor had several other triptans for me to try. As far as I’ve been told, if one triptan works for you, it’s likely that drugs that function similarly (e.g., other triptans) will work for you. Many years later, I tried Imitrex again when my neurologist told me that sometimes drugs will start working again despite having become ineffective years before. To my happiness, Imitrex worked really well again for me until its effectiveness started waning yet again in the last year or so.
It’s now been about a quarter-century since the first migraine attack I can remember, and I’ve tried innumerable drugs for prevention, abortive care, and “rescuing” (when an abortive treatment is unavailable or doesn’t work).
The list of drugs that have stopped working gets longer. That list still isn’t as long as the number of medications (over-the-counter and otherwise) that never worked to begin with, but it’s getting there.
Zomig nasal spray: another one bites the dust
In the last few years, Zomig nasal spray has been my ol’ faithful, the treatment that will work quickly for even the most dramatic migraine attack, even ones marked by rapid onset. When my nausea is too extreme for oral medication (or when my gastroparesis means I can’t metabolize oral meds), It’s the most expensive drug I have. After lots of work done by my neurologist, she medication at last became a barely-affordable $50 for six doses after insurance.
The last couple times I’ve needed Zomig, though, it hasn’t worked very well, if at all. I’ve had two attacks in recent months that required Zomig—both of those times, I’ve had to take a second dose when the first one didn’t work.
This isn’t good news, but it was made worse recently when my beloved local pharmacy told me that, for reasons related to the complete mess that is mediocre insurance in the U.S. in 2018, Zomig had gone up to $400+ for 6 doses.
So now my only treatment that avoids my GI tract altogether not only works intermittently, but I’ll have to pay more than eight times as much in order to even try to see if it will be effective.
When none of the treatment tools work
As I mentioned above, this isn’t the first time I’ve had a medication stop working for me, but I’m pretty bummed. I’m especially distraught because my faithful rescue med (which I also was taking as first-line abortive treatment with tremendous success), Tylenol 3, stopped working. And my other triptans I take orally often don’t work with any predictability.
I tried a new-to-me drug my doctor prescribed just a few weeks ago, Midrin: to my utter disappointment, it hasn’t worked.
It can be hard to keep my head up when my migraine attacks are not only frequent but hard to treat. There’s such comfort in knowing that you have one last tool in your arsenal, one last medication or treatment that will work even when the others are ineffective. Now that my last-ditch abortive medication, Zomig nasal spray, has stopped working and is no longer affordable, I feel pretty bummed out.
Tell us about a time you had a drug stop working well for you. What action did you take? When did you realize it was time to give it up and try something new? Or maybe you have a different sort of example: do you have a drug that used to not work that now does? Share below, and let me and others here know if you have any tips for this particular situation.
How much has your migraine disease changed or evolved over time?