9 is Not Fine

By annequin-harkin

1 min read

What's the deal with nine pills per month for triptans?

I have chronic migraine with a minimum of 15 headache days a month. I've tried all the preventative medications (blood pressure medication, Topamax, anti depressants, anti seizure medications) am on a very restrictive diet (no dairy, soy, gluten, sugar/artificial sweeteners, corn, nuts or eggs), get regular sleep, exercise (when I'm able - I used to love to exercise), yoga therapy, tried sleeping only on my back and even soak in epsom salts and nothing has worked. I'm waiting for my botox approval, and sincerely hope that works.

I am flummoxed at why I can only get nine pills a month to help with the pain? What are people with chronic migraine supposed to do when nine doesn't cut it? Over the counter pain relievers are like putting a band aid on a severed limb for me - useless.

Who's the genius that decided that nine was the magic number?

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amycarl Member
I can completely relate! I feel that I, too, have tried just about anything that anybody has recommended from all the preventive meds to alternative therapies and all the far out suggestions like putting banana peels on my head, inducing brain freezes and even going to healers who tell me my migraines are unresolved past life issues. In the end, my triptans are the only reliable source of relief and while my doctor writes for 12 a month, my insurance only allows 4 at a time at 45 for each 4. Nobody has samples anymore and the copay assistance only can be used once a month. I panic when I'm down to 2 pills and the stress of trying to get my needs met is enough to induce a migraine!!
migrainestl Member
My insurance only allows 12/mo if I order through mail. Otherwise I can only get a couple at a time. However, my Docs are always saying I should take no more than 2 acute meds of any kind per month. I totally understand their reasoning due to medication overuse headaches, but chronic migraineurs are chronic regardless in my experience.
1. migrainestl Member
 I meant 2 acute meds per week! Not month, so total of 8 pills per month....
Katie M. Golden Moderator
Anne, I think there are probably 2 factors at play. From a medical perspective, your doctor is probably worried about Medication Overuse Headache (MOH). If you use too many triptans, it can actually cause you more headaches. <a href='https://migraine.com/blog/help-how-can-i-not-overuse-migraine-medications' target='_blank'>http://migraine.com/blog/help-how-can-i-not-overuse-migraine-medications/</a> The financial answer to this question may lie with your insurance company, which of course doesn't seem fair at all. If your doctor will allow you to have more than 9 pills a month, but your insurance company will only pay for 9- you can get a prior authorization for the full amount. This article may help in maneuvering around the insurance company issue. <a href='https://migraine.com/blog/why-do-insurance-companies-limit-prescription-migraine-medications-what-can-a-migraine-patient-do' target='_blank'>http://migraine.com/blog/why-do-insurance-companies-limit-prescription-migraine-medications-what-can-a-migraine-patient-do/</a> It's so hard to find a balance as a Chronic Migraineur of how to treat our daily Migraines. Throwing rescue drugs at them on an almost daily basis could also have long term side effects such as liver function issues. I encourage you to stick with yoga to diversify your ways of managing the pain.
joy-hackett Member
You have my sympathy. In England we are only prescribed a max of 6 triptans per month, which they are v strict about to limit medication overuse. Also triptans cause rebound headaches. I've had my first set of Botox injections and have been really disappointed not to have had a reduction in the number of migraine (about 3 per week) but it has helped with the headaches in between. I'm due to have the second round in April and the consultant says the second lot are often more effective. Hang on in there!
annequin-harkin Member
I don't believe in Medication Overuse Headache - in my journey of trying everything under the sun (including wearing frozen socks as that was supposed to stave off pain) I went over three months without using any kind of triptans or over the counter pain relievers in order to see if that would help. Not only was it excruciating, but my headaches did not change in number of days or strength. I think the medical community still knows very little about migraines. I read every study I can get my hands on (like a lot of us) and find many of them to be either contradictory or highly simplistic. To me, it seems like there's more speculation than science available to migraine sufferers. That's why I really appreciate this forum to be able to hear others' experiences. It helps to know I'm not alone, although I wouldn't wish migraines on my worst enemy.