Ok, I’ll try not to make this a novel. I am a 46 year old woman who has had migraines since I was a child. I’ve been on many, many preventatives throughout my life from Topamax to Botox and a lot in between. The only thing I’ve been using for the past 4 years is 10mg amitriptyline at night and rescue triptans (Maxalt and Amerge).
Well, in the past 6 months or so, perimenopausal symptoms have really started kicking in (hot flashes, irregular periods, etc). At that same time, I had a big spike in my migraines/tension headaches. I have been having a lot more headaches and they are harder to treat. So, I have been using a lot more triptans. Amerge is the best for me. It lasts a long time and works well. But I have noticed that as soon as the meds wear off, my migraine is back. So I increased my amitriptyline to 20mg per night. No difference.
Then it occurred to me that it might be MOH (Medication Overuse Headaches). So, I stopped my triptan use 6 days ago (I believe I was taking triptans about 3 times per week, some weeks more). Now, keep in mind, I have never had rebound headaches after having migraines for most of my life. For the past 6 days without triptans, some days have been brutal. The first day was the worst. It was like a band of pain around my head all day. The next day wasn’t quite as bad, then really bad again, then not so much…in other words, all over the place. Yesterday (day 5), the pain was quite minimal so I figured I was through the worst of it. Well, today I woke up with a rocking migraine (my usual migraine location – on the right hand side). I took Naproxen Sodium with the hopes it would helps a little…did nothing. I feel like an ice pick is stabbing me.
I guess my question is…how do I know if I am having rebound headaches or if I’m just going through a rough patch with my hormones all over the place and having tons of migraines? Oh, how would I love to have a triptan and this takes tremendous will power to not do it. Part of me wonders if they’re not rebound and I’m suffering for nothing.
I have an appt with my neuro early next month, but until then, I’m not sure what to do.
Anyone had MOH here, and if so, how did you treat it?