Migraine - Rebound

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Hi everyone, after some advise, snce 2014 I suffer daily migraines, tried all alternative therapies/ medication ..

I take Naratriptan, daily Dr say's I'm suffering from rebounds possibly 

I've tried twice weanig off, cannot withstand the pain, I asked Dr for support, none offered

I've had a Steriod Injection, no difference

now the Dr wants to limit the Triptan, as you can imagine the only pain relief, I get I get more anxious 

Surley it is my right to have medication if it help's for now, until they offer support ??

I went on holiday first time in 2 years, the Dr refused to give me extra, in case I needed, with weekend surgery closed and 2 day's for prescriptions to be processesd, I am stressed..

No one wants to take medication, unless they have too .

Please advise  

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  • Posted

    Shaheen,

    I've never used the medication you are using but found one study online where 2.5 was used as a preventative therapy. All other information points to medication overuse headache which actually causes a migraine type of headache. Early on in my migraine treatment I had a neurologist tell me to never take another over the counter pain medication, he explained MOH and said over the counter meds are too easy to use too frequently. I had been popping aleve and excedrin migraine like tictacs and stopping them sucked, so I'm sure stopping a triptan would be a lot worse. The problem with MOH is that the only treatment is to stop taking all pain medications. You are going to go through a withdrawal period, so things will probably get worse before they get better. Once you detox you can resume recommended use of the medication, and they can rule out MOH which will exclude you from other treatments such as botox. I read some people go into the hospital to detox, or taper the medication. I would discuss those options with your doctor since they want you not to take it daily.

    Do you still experience headache frequently? If not I would bring up the study of naratriptan as a preventative. Did you change doctors? This would explain a differing treatment approach. If not, a conversation for your doctor should address what changed that they were ok with prescribing a daily dose for so long,allowing you to get to this point but now all of the sudden they want you to stop. If they are adamant you have MOH or other health risks, such as heart problems that brought on their change of treatment there few options. Your expectation probably should not be to continue triptan/pain medication daily, since it would not change anything with MOH. Instead maybe discuss an expectation of a taper in dose such as alternating 2.5 and 1.5 with a goal of 1.5 daily. Then lessen frequency, such as 1.5 every other day, then every three days etc until you are off. I know you mentioned tapering, was bad, but it will probably NOT be pretty. They should expect to be ready to admit you to a hospital if it comes to that if a taper isn't working, especially if they are the ones who allowed you to get to this point. I suggest possible trigger point injections and nerve blocks for temporary treatment. I had them and got worse before I got some relief but again some relief. If you want more detail on those PM me. I've also read about migraine treatment where people get a pic line in an inpatient setting where they administer lidocaine, not sure if it would contribute to MOH but wouldn't hurt to ask.

    I recently tapered off of an antidepressant I had been on for 7 years on instruction of a new headache clinic doctor. Even tapering was rough, and it took about a 1 1/2 - 2 months. I was an emotional roller coaster the whole time, and for a while afterward. I was in h*ll. Though I haven't gone through your exact situation, I understand your fear.

    Jenn

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    • Posted

      Thank you so much for responding,I will look into the points,you mentioned.. I only take half of the Triptan, if pain continues, then I take the other half... Will let u know how I get on thank you Jenn..
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  • Posted

    I agree 100%! But I don't have an answer. Find another Dr maybe? Rebounds are a great concern, but so is our real pain. It sad when we have to plan vacations around our medicine refill date. I hope you get to the point you don't need medicine, but until then just know you are not alone.

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    • Posted

      Poor you.  I have been where you are twice and there is light at the end of the tunnel.  The first time I was given three days of something to help with the withdrawal and the second nothing as I was made to feel like an addict.  The meds are restricted because of the expense and also because too many are not good for your liver etc.  You must ask your Dr. for help, see a different one if yours is not sympathetic.  I know it is scary contemplating being unable to take something when you are in so much pain but you do need to do it. Both times I have gone without for 6 months which was too long and difficult for normal life, probably 3 months would have been enough.  The headaches do reduce although I know at the moment you will find that hard to believe.  Coming off the drugs is not easy and I am determined not to get sucked into taking so many again and having to repeat the process.  I wish you good luck and hope you can find some help.
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  • Posted

    I don't know if this reply will be popular, but I have a very good doctor friend who knows a bit about migranes who says that rebound headaches DO NOT come from triptans, they come from paracetamol/ibuprofen (i.e over the counter meds).  He says you cannot become adicted to triptans as such - but I said I was addicted to them in terms of 'i am adicted to not having a migrane' if you get me?!

    Anyway - it's obvioulsy not an ideal situation to be taking loads of triptans, but i know how it can happen....

     

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    • Posted

      Hi Sian, I agree , I keep saying to the Dr's I don't think its rebound ..

      Once I had no Triptan's for 3 week's, so what re started my migraines then ...

      Thank you for replying

       

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    • Posted

      I mainly use triptans and Fioricet. I've had Dr's tell me they'd rather I use Fioricet more than the imitrex (a triptans). So go figure. Like everything else, each to their own. I've always heard Fioricet is much worse for rebounds. I think we'd all like to be migraine free, but it's choosing quality of life and what works. Even with these two meds I can have a break through migraine that nothing helps. Urg, it's all frustrating. Causes and treatments.

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    • Posted

      I have not heard of Floricet - I don't think we have it in the UK? My doc friend  told me UK are hesitant to prescribe too many triptans as they are expensive, and as you know know our healthecare is FREEEE!

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    • Posted

      Fioricet is a blend of barbituate/Tylenol//caffeine. Some Dr's are concerned about the barbituate in it has habit forming. It's a very small amount and used as a pain killer.

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    • Posted

      How much do you pay for your triptans in the US, and can you buy triptans over the counter?

      We pay £8.40 ($11.17) per prescription (so I get 12 triptans/zomig on my prescription)

      But if you buy it over-the-counter at the drug store (Boots) it's £8 ($10.64) for x2 tablets!!

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    • Posted

      It is prescription only. 9 to a pack. I cut them in half. Everyone pays something different. But I usually pay around $17.00 US for 9 or 18 if im cutting them in half. They usually (imitrex/sumatriptan) come in 100mgs tablets.
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