Rebound Migraines, Presyncope, And Rant

[mkoven]

I don't know which thing to focus on. This menstrual cycle I decided to try ibuprofen to pre-empt my migraines. I started taking it about five days before my period and then through about day four. It really did help eliminate headaches except for the one I got on the first day of my period.

So after nine straight days of taking ibuprofen regularly around the clock, I wanted to stop-- figuring my period was almost over, and I'd be on the other side of my hormonally triggered headaches. Well, now I think Im getting rebound migraines. As I have been battling one migraine after another since stopping the ibuprofen. So nine days of ibuprofen is enough to get me to rebounds???

So I'm pretty grumpy about that. And my feeling like I might faint had been a lot better recently-- till this morning. I feel really close to the edge of greying/passing out. Anyone know if coming off ibuprofen could make my ncs worse???

To top it all off, I'm still without a neurologist for migraines-- so the ibuprofen was my unsupervised idea/plan. Of course calling a doctor would be in order. But in addition to not having a neurologist, I got a letter yesterday from my pcp's office yesterday, saying that his practice will be getting much smaller, as he's taking on some major administrative/teaching duties. So he will be even harder to get to see. Medical access in this town stinks. And I don't know that trying to talk to someone the day before Thanksgiving is likely to bear much fruit.

So I'm feeling migrainey( a word?!), on the verge of fainting, and with little medical support. I guess this post is a combo-- question about ibuprofen withdrawal and rant.

[ajw4790]

Sorry about your migraines!

Ibuprofen thins your blood, which could cause more of the fainty/syncope symptoms. Normally as a preventative you would want to try something like a beta blocker, and that normally wouldn't take a migraine dr. to prescribe. Also, have you tried to alter your periods with birth control? I was just thinking it may help. Also, have you tried triptans (migraine meds)?

Hope you find something that can work for you!!!

[mkoven]

Unfortunately I can't take beta-blockers because of severe allergies and asthma. (My allergist told me he didn't want someone with a history of anaphylaxis to take them, as they can worsen reactions and make epipens less effective).

I clearly need a new doc, as I get "complicated migraines"-- with onesided weakness, vertigo, in addition to the standard head pain, nausea, wanting to avoid sound and light. (I've ended up in the hospital twice, as they looked like strokes, but everything was clear.) My neurologist recently "fired" me because I had bad reactions to too many of the meds he typically prescribes. I'm still looking for a new doctor. Because they are complicated, no one has wanted me to take triptans either, as I guess there's a higher risk of stroke.

So the preventive ibuprofen was my imperfect stopgap approach till I could find someone who will take on a patient with my history (severe allergies to many meds, eds, pots/ncs).

[doctorguest]

Hi Michelle,

I see you're dealing with more headaches lately. Well, I think at this point, you will have to travel out of town to a specialized headache center to see a neurologist who specializes in headaches. You may only need to see them once for a consultation, and then you can followup with your local physicians.

To answer your questions about ibuprofen, yes, you can get a medication overuse headache (MOH) from taking ibuprofen non-stop for 9 days. This is why we recommend taking it not more than 2-3 times per week rather than daily. Secondly, ibuprofen is a drug that promotes salt absorption from kidneys, thus improving blood volume and probably helping with presyncope and energy. This may be why going off of it results in the reversal of its beneficial side effects, and thus, causes you to have more dizziness and presyncope.

Finally, if you were my patient, I'd start you on topamax daily. Another option is a trial of a low dose of elavil at nighttime for headache prevention. For acute headaches, you may still use ibuprofen, but not on a daily basis. There is also an option of getting IV medications for acute headache, but that would require you either going to an urgent care center with your doctor's prescription and specific instructions or going to ER - something I am sure you'd want to avoid.

I am sorry that you got fired by your doctor because of your multiple medication allergies. I find this despicable and extremely unethical. Best of luck to you!

[mkoven]

Thank you, doctorguest, for your recommendations. That's really helpful.

If I'm looking for a headache specialist, what would you recommend? I can google, of course, but that seems a little unfocused. I'm in Champaign, Illinois. The nearest big city is Chicago, but there is also Indianapolis, St. Louis, and closest, Springfield (though it's not so big). I looked at Northwestern's neurology department, but couldn't really determine anyone's specialties. Or should I look for a place that advertises itself as a "headache center" ?

[doctorguest]

I am sending you a pm.

[Jan]

I also get menstrual migraines. My doctor recommended doing almost exactly what you have done. Only not to start the ibuprofen until the day the headache usually starts and then take it every 6 hours until the headache goes away. I don't take it every six hours unless the headache comes back and stop when it doesn't. I have never had a rebound problem. I also found adding caffeine helps.

It does make sense to maybe start a bit closer to your period or the time when you usually get your headache so you don't have to take it for as long. And quit when your headache lets up. Make sure you take it with food if you take it that much as it is harsh on the stomach.

Some suggest weaning yourself off of the med that is causing the rebound problem as a way of getting through it. The headaches you are having now may or may not be due to rebound.

It is really too bad that you are still having head pain since it seems like the ibuprofen worked really well during your period.