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Meds To Prevent Migraines


goawaypots!

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What has worked well for you when it comes to medications for migraine prevention? I am already on a beta blocker but it does not help my migraines. Many of my POTS symptoms have improved but I'm still struggling with migraines (having 2-3 per week). Has anyone tried botox? I know seizure medication are sometime used but I would like to avoid seizure meds if possible due to the fatigue that many of the seizure meds can cause. Any info would be greatly appreciated.

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Sorry about your migraines goaway. I've suffered them all my life. Imitrex seems to be the only thing that works with any kind of consistency with me. I have multiple drug allergies and my neurologist was trying all kinds of variations with anti-epileptic meds and antianxiety/antidepressant agents. I have allergies to products with aspirin/ibuprofen in them and cannot take NSAIDs. Since my blood pressure runs low, docs have always stayed away from beta blockers and calcium channel blockers with me, too. I've tried every anti-migraine prescription there is. My sister does better with Relpax than immitrex. Just goes to show you how we all respond differently. I may need a nausea medication when the migraines get full blown. I've asked for that in suppository form as once I am sick to my stomach, no pill is going to stay down. Some nausea medications will potentiate the effects of your migraine medication. It would be something you would need to talk over with your doctor. For some reason a heating pad to my head helps relax the spasms in the vessels and is more soothing to me than the ice packs. I like to make sure the room is dark and quiet.

I've read that sniffing Chinese mustard will help but that did not work for me either (when I say I've tried everything I really have). I do take magnesium supplements at bedtime.

Wishing you better health and relief from those migraines.

ruby

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I tried topamax and that made my pots go wild. I am now on depakote as a preventative and that has helped considerably although I still do get them but fewer. My fatigue now is no worse than it was prior to depakote. I also take maxalt (now I actually take the generic for maxalt) as a rescue med when I actually get a headache. Because I have mcas, I am not willing to experiment with botox. I think the meds options for migraine prevention are another group of treatments where the side effects can be as bad or worse than what your treating. Each time we've changed my med I just hold my breath and cross my fingers.

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Tried gabapentin and couldn't tolerate that, but I do well on Topirimate as a migraine preventative. I use Relpax and Phenergan when I get a break-thru headache although with the Topirimate I get fewer and less intense migraines now. Frequently I can get by with Exedrin. I don't think my fatigue is any worse now than before I started these meds and the relief of not having 20 migraines a month has been wonderful!

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I forgot to add that I have had botox twice. It wasn't beneficial for me completely but I did notice some improvement.

the reason I asked about the betablocker is because Inderal (propanalol) is a Beta Blocker that is also prescribed for migraines as well. I even believe off label it is given for anxiety.

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My understanding (from having tried propanalol for migraines) is that you have to use at least 60 mg as the lowest dose for a migraine prophylactic and that's too high a dose for many POTS patients- according to the research out of Vanderbilt.

Back when I was in college and used it for migraines I was on 200 mgs and it was helpful.

My PCP tried it at 60 and 80 mg a couple years ago to help my migraines; it didn't. My POTS neuro was shocked that I "could even stand up on that kind of massive dose" when I saw him the first time.

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Thanks for the input. It's good to hear what has worked well for others.

Sarah, the beta blocker that I take is propranolol. However, I can only tolerate a very small dose. I seem to be very sensitive to beta blockers for some reason.

Chaos, 200 mg of propranolol would probably kill me. I am impressed you could tolerate a dose that high. I don't think I would ever be able to tolerate anything close to that dose. I currently only take 5 mg twice a day but it is amazing how much this very small dose reduces my standing heart rate.

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Hiya, Chaos and Goawaypots,

Chaos yep I agree with you about the initial dose of Inderal for migraine.. but I take 720mg (240mg tid) and it does help with the migraines somewhat I think as well as the bp/hr..

This is for anyone interested looking at this medication for migraine use. This little synapse was taken from www.migraine.com which I find a lot of great migraine topics on. "Inderal LA Dosage for preventing a migraine attack: The starting dose of Inderal LA for preventing a migraine headache is usually a single 80 mg capsule taken once a day. Most people respond best to between 160 mg and 240 mg once a day when taking it to prevent migraines. If Inderal LA is not helping to prevent your headaches after four to six weeks, talk with your doctor about trying a different migraine medicine."

Anyway, I could see how an initial low dose for POTS patients would be a whopping amount. On ncbi's website I read a great deal about low dose propranolol when used as a migraine abortive as well as a preventative. I guess anything that could potentially help with a migraine is worth a shot. This is an old 2 pg case report but was the first time ive seen it used in abortive measures. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1021497/?page=1

Sorry to hear that you both suffer from these awful things too!

Be Well,

Sarah

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cbakl,

that's so funny you mentioned that. Zomig was the only triptan that has worked for me. I can no longer take it because it raises my blood pressure also.

I receive migraine treatments sometimes. Some migraines last for 20+ days and I just give up and surrender. Have you had any of those?

Take care,

Sarah

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heres what i have tried, and everyones different so something that didn't work for me could work for you

-verapamil- which did not work for me, was a partial preventative but instead of headaches i would get really wierd episodes which were not a normal type of reaciton so it could work for you

-amitriptyline- which i'm currently on, and is the only thing that stopped the headaches other than a random one, or if i eat my trigger foods, and for some reason is the only med that didn't give me side effects but i started at a low dose and moved up very slowly becasue i'm supersensitive to meds now

-also tried atenolol but it didn't do it for me as far as stopping the headaches

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