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Treatments for chronic migraine and bipolar

I have chronic migraines and bipolar type II. My main bipolar symptoms are depressive, with occasional spells of hypomania. I have had chronic migraine since 2009 but this has recently worsened to 3 x migraines a week each lasting up to 48 hours. I am never pain free.

I am concerned because the last time my migraines got this bad, it came shortly before a serious mixed (depressive and hypomanic at the same time) episode of bipolar.

I currently do not take any treatment for either condition, and am considering my treatment options. I have previously tried amitriptaline and gabapentin and propranolol for migraines, and lamotrigine, lithium and a whole bunch of SSRIs for bipolar. Nothing has ever worked and very often the side-effects (exhaustion and concentration) have made it impossible for me to go to work.

Has anyone had any experience of treating comorbid chronic migraine and bipolar depression? Topimarate and sodium valproate seem like possible options but I am not sure if I would get a prescription for either.

  1. CherryDarling,
    I'm so sorry that you are dealing with both migraines and bipolar disorder. Those who are bipolar have a higher risk of also having Migraines- so lucky you! Here's an interesting article on the connection between the two:
    https://migraine.com/migraine-and-mental-health/bipolar-disorder/

    One medication you didn't mention having tried was Depakote. It has been known to help both conditions.
    https://migraine.com/migraine-treatment/depakote-and-depakote-er/efficacy/

    Sodium valproate and Topamax are also known to help both. If you are seeing a neurologist or psychiatrist, these are all well known meds to use to treat both conditions so it shouldn't be too hard to get a prescription.

    I hope this helps!
    -Katie
    Migraine.com MOderator

    1. I take Zonegran for migraines but it is also used to treat bipolar depression and I am really happy with the results. My headaches are lessened and my mood is greatly improved. I hope you find some relief!

      Torrey

      1. I also have chronic migraines and Bipolar Type II. I am currently taking lamotrigine and duloxetine for my bi-polar and amitriptiline and verapamil for the migraines. The bi-polar was diagnosed over 15 years ago and I had learned how to cope and keep tabs on myself so I was able to tell when I was about to hit a depressive cycle and possibly avert it. The migraines were just diagnosed about 4 years ago and I have had a lot less success dealing with those.
        The frustrations of living with migraines keeps me a lot closer to the edge of sliding into a depression. If I don't take my bi-polar meds for a few days (don't we all tend to self-medicate?) I can feel the depression taking over. So, I urge you to find a good psychiatrist and therapist to help with the bi-polar and depression. The migraines probably won't kill you, but the migraines with the untreated depression will be more likely to have you do something really stupid to yourself or someone else.

        1. I was on Lamotrigine, which was supposed to help me with both, unfortunately it didn't for me, maybe it might for you.

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