My neurologist has prescribed Thorazine to help break a migraine cycle. I am to take one 10mg tablet each hour up to a maximum of five tablets per day.
I started this yesterday and now the migraine is much worse. I woke up at three this morning, after doing the Thorazine yesterday afternoon, with such a horrible migraine! This morning makes yesterday, forgive the cliche, seem like a walk in a beautiful park.
I am very reluctant to use the Thorazine again today.
Chris, you’re the kind of patient that has probably looked up side effects and contraindications etc of thorazine, so this is probably going to be repetitive…
This is a drug that can have some very serious side effects. You and your doctor should really have a game plan in place before you even began taking it. If something goes wrong, what should you do? Who should you call? How can you get advice while beginning this new medicine?
Can you call your doctor and tell the staff there that you have started taking thorazine and that you are very concerned about side effects and need to talk to the doctor?
Thank you for the concern and advice. I appreciate it!
You are absolutely right about researching medications before using them, even when prescribed by a trained and certified provider. I always research any new medications and I would encourage everyone to do the same! Not to get off topic here, but the relationship with one’s physician, whether for migraine or simply primary care, should ideally be a partnership where, as the patient, you work with the provider. This includes being an active participant in your treatment and, certainly, doing your homework when it comes to treatment, including medications!!
Back to the Thorazine… I have taken Thorazine in the past as part of an attempt to break similar cycles of increased migraine frequency and intensity. I have also taken it as a daily, low dose, part of a preventative program. With a history of tolerating the medication well I was not too worried about any serious side effects going into this latest adventure with Thorazine.
My biggest concern was the idea of basically feeling so sleepy I could not function. The dosing was 10mg tablets, one per hour up to a maximum of five each day, for a total of 50mg. In my previous experience with Thorazine I had taken one 25mg tablet at bedtime. So the idea of going twice that over the course of a day did not seem too scary to me (again having tolerated it well in the past). I know from my previous dose of 25mg daily, that this medication does have a big side effect of sleepiness. I knew that going to a maximum of 50mg was likely to, as my neurologist told me, result in retreating to my room to sleep.
Well, the attempt to break the cycle using Thorazine did not work. In fact, the migraine seemed to get worse after the first run at it with the Thorazine. I did the full course of five 10mg tablets spread out over, in this case, an eight hour period. By the fifth 10mg tablet I was so tired I simply mumbled to my wife that I was going to bed (at six in the evening) and proceeded to sleep through the night, almost. I awoke at three in the morning with the migraine back, even worse than where it was the previous day. Continued use of the Thorazine did nothing to break the migraine cycle, to lessen the intensity level or to slow the frequency (which is basically non-stop at this point).
I have been communicating with my neurologist along the way. She has now started me on a course of steroid as another attempt to break this cycle. This is the beginning of day two with the steroids. So far I have not noticed the migraine backing off or backing down, but then again, I only have one day under my belt. The steroid runs for nine days with a gradually decreasing dose as I move through the days.
I am hopeful, I must be, that this will work. I have an face-to-face appointment with my neurologist on the 20th of August, next Tuesday, for my third round of Botox injections. In the past, rounds one and two, the Botox has brought about some relief, but seems to take about three weeks to “kick in”.
Importantly, I will have an opportunity to discuss other things with my neurologist on Tuesday. A big topic will be looking at making changes to my current preventative medications. I am on only two at the moment and it is clear that these are not effective in helping me manage and control the migraine. In the past I have been on more than a few preventatives concurrently at extremely high doses. I certainly do not want to go back to a state of “zombification by medication”, but I do think it might be time to consider taking on some different medications in the preventatives. Beyond medications I intend to simply state the facts, namely that I am at the end of my rope with these darned migraines. I am hopeful that the Botox will help move me into calmer, less painful waters, but what about the next time, just before my fourth round of injections? I simply cannot stand another bad stretch like this!
I don’t know what my neurologist will have to offer in the way of changes and improvements to my current treatment path, but I hope she has something. I know what happens when I start to lose hope. As I was telling a friend yesterday, I don’t want to go into that dark, dark hole again. Loss of hope is a very bad thing.
So, I look forward to the 20th. I hope that I have some good days, or hours, between now and then.
Reading your post above was like reading my own. I am at the end of my rope with these things and praying that my appointment with the new Dr next week will bring some new ideas and treatment strategies. I can’t continue on the way I am going now. So here’s hoping that we both can find a new path next week. Your appointment is on Tuesday and mine is on Wednesday. We should compare notes after 🙂 I, of course, have not tried botox yet. They will probably go that route with me. I have been reluctant for two reasons…one- the cost, and two the fact that I have had bad reactions to injectable meds before where the med needs to be mixed or diluted to inject, and it would be aweful to have a similar reaction after 31 injections.
And when I had the other reaction it wasn’t until later that night, so it’s nit like I would know right after the first Injection. I looked it up and no one seems to have adverse skin reaction (what happened with the other med is my arm swelled up like a balloon and was very painful and on fire for about a week). But no megastar reaction to this other med except me either. Anyway, here’s hoping we both figure something out and have some pain free days coming our way.
I am frustrated right now. I am suppose to drive to meet a close friend after work today (about a four hour drive). We were going to have dinner and maybe do something tomorrow, museum or book store, or something). I don’t get to see this friend very often as he travels for work. So, of course, as I move into the afternoon, at work, the migraine, which had finally “broke” this morning (for about two and a half or three hours) has come back. In fact, it is coming back, strong.
In reviewing my migraine diary (kept in Excel spreadsheet) I see that I am “maxed” out on abortives except triptans. I cannot take triptans and drive. So, I am left, once again, at the mercy of the migraine. If it backs off I can make the drive. If not, I choose, drive four hours and then try to be a “real person” or call off. The problem with calling off is that my friend specifically flew into a different airport so that we could meet. If not, he could have just flown home.
I know that frustration and anger and general “pissed off”-ness do not help the migraine, but today I am not dealing well.
I know that my appointment with my neuro is this coming Tuesday. I know I will get my next round of Botox and I suspect in three weeks I will be in a better spot. That, however, does not help me rigbht now, or tomorrow or the next day.
At times this condition, this disease, this curse, seems completely intolerable.
I had my appointment with my neurologist this afternoon. We proceeded with the third round of Botox injections, which is what was expected.
Beyond that the plan is to pursue an inpatient program as I am in a bad stretch that is not responding to any rescues. Additionally, even with the Botox the limited relief is short-lived and leaves me in some pretty tough territory both just after the injections (while waiting for the Botox to kick-in) and after the effects of the Botox wear off.
So, my neuro is working to get me admitted into the Michigan Head Pain and Neurological Institute’s inpatient program. She did not think this would be an issue as I have been a patient of their outpatient clinic twice in the past. The good thing about this is that Dr. Joel Saper, founder of the clinic and one of the best, I am told, migraine specialists in the country, oversees the inpatient participants.
I am trying to see the hope in this plan. The reality is that some darker thoughts are rolling in as well. I will have to miss work (running out of paid time off). I also feel like this is “the end of the line” and that if it doesn’t work I don’t know where I would go next.
I know some of the darkness comes from the fact that I have had an severe increase in frequency and intensity of migraine in the last several weeks and, in fact, am feeling one as I type this update.
For now, I at least can look forward to some relief in the coming weeks from the Botox. I am sure to learn more about the inpatient program in the coming days and will post that somewhere at Migraine.com.
I appreciate the concern and support of all the members here.
Thanks for letting us know about your appointment, Chris. Good to hear you have a plan. I’ve met Dr. Saper, he is extremely knowledgeable and has pretty much “seen it all” when it comes to migraine and headache disorders.
I know how hard it is to keep away those “dark thoughts.” But try to take one day at a time. When I’m in the middle of a nasty migraine cycle or “crisis” I find looking ahead is too overwhelming. It’s better for me to take it one day at a time.
Well, I have to admit I wasn’t expecting that to be the outcome of your appointment. I would probably be feeling the same mixed bag if I were you. I hope that this program is able to help you find some relief. Hugs,
Hi Chris, You will love Dr Saper I predict 😉 I know it feels like you’re at the end of the line, but you need to think of treating it much like a tree…
The top of a tree has many branches that come from a single (or sometimes multiple) trunks. Try to think of the tops of the tree – its branches and leaves – as the obvious treatments. But when you dig below the surface, the roots spread out just as far as those branches, yet are even stronger and greater in number. The number of roots and rootlets in a tree are like numbering the sands of a sand dune.
Try to think of going inpatient and working with Dr Saper’s team as digging below the soil to find the roots.
There are many things to be tried in an inpatient program. There is no cookbook science there, I promise you. What it does allow is for your doctor to see you daily and try several different things.
Dr Saper will not give up on you. You have to hang in there and give him and his team a chance to start digging.
Sickening how antipsychotics like Thorazine are being used as a means to cure migraines. As a board certified Psychiatrist I find that medications like these do more harm than good for most patients and with the fields of medicine and neurology constantly advancing I would recommend you consult your PCP about an alternative (less dangerous) solution to your migraines.
Drugs like Thorazine, act by antagonizing (disabling) the dopamine receptors in your brain which are responsible for more than just feelings of satisfaction, they makes your muscles move. Parkinson’s disease is caused by the death of neurons in the brain that use dopamine as their transmitter. Long term use of these kinds of psychotropics can lead in many cases to permanent impairment in cognitive function as well as long term nervous system damage. (Thorazine Shuffle?)
I would first look into homeopathic remedies for these kinds of headaches: B complex vitamins, peppermint/lavender oil, skullcap.
Only use these kinds of drugs as a last resort and remember to talk to your doctor about what works for you, after all, you know your body better than anyone else.