Migraine Medications

I was asked by someone what kinds of drugs or medication have I tried for my migraines. Well, I confess, I haven't been to a specialist, or even a doctor, about these in years and years. After my first migraine, a huge surprising attack which I didn't even know what it was, back in my twenties, I just figured it out as part of my life.

Back then, the neurologist I went to see did not suggest anything specific. I have only had two episodes and he said it sounds like migraines alright, and to get back to him six months later for further analysis. I never went. Instead I did some reading about migraines. I probably should give some of the newer drugs a try, I guess, as I have been reading up about them. I confess, I don't like meddling with brain chemistry, and at that, I prefer in a way, to stay away from anything that isn't a common OTC drug. For now I use something as simple as ibuprofen or sometimes a mix of that and Tylenol. Needless to say, do not try that at home just because you read about it here. Anyway, good question and I probably should look into some of the specific migraine stuff like Imitrex or Zomig. I know that these use tryptans (don’t ask me what they are exactly lol) and are supposed to target migraines directly. Ok, making mental note here to indeed talk to my doctor about them.

Actually, typing along, I ran a search on Wikipedia, and here's what they have to say about tryptans and Imitrex: " ften, serotonin levels in the brain become extremely erratic before the onset of a migraine. In an attempt to stabilize this, sumatriptan is administered to help aid in leveling the serotonin levels in the brain. Sumatriptan is structurally similar to serotonin, and is a 5-HT (5-HT_1D) agonist, which is one of the receptors that serotonin binds to. The specific receptor subtype it activates is present in the cranial and basilar arteries." Sounds promising indeed.

Ways in which migraines end

I blogged about the way my migraine ends. I've been re-reading in Oliver Sacks' excellent book about migraines again today. Thought I'd drop a note about it here as well. He does mention there that migraines can end in one of three ways. The first is that of falling asleep, where a patient just falls asleep at the end of the acute phase, much like the sleep that follows an epileptic episode. The second way he calls "lysis". I checked for definitions its medical one is "The gradual subsiding of the symptoms of an acute disease." Sacks then goes on to describe the forms a lysis can take in the end of a migraine, and he does mention excretion, or emission, being a prominent part of it. According to him, the kind of body fluids which are emitted varies between patients. He mentions vomiting, tears, sneezing, urine, sweat, nosebleeding, nasal mucus, diarrhea and menstruation, all as forms of possible emissions which show up at the height of a migraine and bringing on a closure.

The third way, that Sacks has there is a crisis. He says that some of his patients were able to end an episode by creating a physical "crisis" of some sorts; in essence, washing their body/brain with adrenalin. He describes a patient that used to bring a forced ending to his migraines by either sex or wrestling. Another patient said he can end an episode by running around, shouting and doing all he could to artificially increase his adrenalin levels. Interestingly, I could actually relate to that in a way. I was once lying in bed, going through an active migraine, laying there and suffering. My two kids were at home, aged 2 and 4 back then. I had called my husband and he was on his way home, but for now they were with me, in the next room. Suddenly, my 4 years old bursts into the room saying, "Mom, David opened the door and went outside, I think he's heading for the main road". Well, you can imagine my response, migraine or not, I jumped out of bed like a rocket and sprang outside to get a hold of the little one. Only after I got him (safe and sound, he didn't make it as far), I realized that my migraine was gone. The sudden rush of adrenalin just made it go away. I don't think I can recreate the same setting again though lol, no intention of putting my kids at risk, and it needs to be spontaneous anyway.

Post-Migraine with me

Been meaning to get back to it and blog about the post-migraine phase, so I'll do that today, I think. I described the violent course of one of my migraines last time. It is usually like that for me. I am not even sure if I am getting an aura or not. Definitely not the visual kind of aura that is usually described when referring to Classic Migraine, but I do sometimes have an olfactory aura, I think, where I imagine smells. I also have difficulty talking, not slurred speech, but just sitting there and not having the "energy" to talk. Thoughts racing through my mind, but not making it past my lips.

Anyway, either way, the migraine episode itself has formed a regular pattern with me, not a very unique or exotic either. My symptoms form in a wave which includes: an overall body storm with a general feeling of anxiety, sweating, and physical restlessness to the point of having to pace or move my legs somehow (even lying down), bowel spasms including diarrhea and nausea. This all builds up gradually over the course of an hour or so, getting worse and worse, till I finally vomit. Once I do, it's almost like instant relief. The headache subsides, the nausea goes away. My whole body relaxes. I drag myself back into bed, and just zombie out there. It's hard to describe the feeling. I am not even sleepy at first, just feeling this not unpleasant sense of a closure. Paralysis is a word that comes to mind at this point, although it's not a matter of not being able to move. More like not wanting to. It just feels better to stay like that motionless and empty. I just lie there for a while, propped up on some pillows usually, and I often fall asleep, just drowsing into a thoughtless, dreamless, slumber.

There is something very attractive about this phase, actually. Getting to that point is pure hell, but once I’m there, I just don't care about anything anymore. I don't know if this is making sense even. I sure don't want to go through a migraine, nothing is worth the pain and misery, but in the end, when I just lie there or sleep like that, it's something that I can't usually achieve any other way, and it is rewarding.

a migraine episode

I knew I would get a migraine on the weekend and indeed I did… The weather is a trigger for me, with hot dry days being exceptionally hi-risk for me. Well, it is such a day on Sunday. Not the height of summer yet, by far so only a mini-heatwave at this point, but it was enough for me to feel some pulsating pain in my head in the morning. I knew I had to watch it, so had extra amounts of water to drink. Now, I've had weekend migraines in the past, and frankly, on Sunday it got me wondering if maybe I was "expecting" one. I meditated for a while and tried to keep it at bay, but I didn't take any painkillers to push it off. I thought maybe drinking plenty of water and meditating would be enough. I did feel better, got into quite a nice mood even. Then some friends of ours called and invited us over for lunch. They decided to have a spur of the moment BBQ and thought we might enjoy joining them. It was a spontaneous even for us as well, but we figured, why not. So we went over, had some nice food, and talked to people (they had their neighbors over as well). Then it sort of hit me, feeling weird and spaced out, and a pulsating pain in the right side of my head, right behind my eye. I didn't have any major painkillers with me, and I asked Deb, all she had was Tylenol. I popped in a couple of those, but I could tell it was too little too late.

My husband packed me into the car, I think he apologized for me, I was getting too dazed to talk much or even to listen. Fortunately it was a short drive home and I headed right into my bedroom, where my DH helped me darken the room and left me lying in the bed. He knows better than to bug me at those times, he just leaves me in peace, which is all I want and need. I lay in bed for God knows how long, just lying quietly, suffering and feeling the beginning of the nausea. The pain in my head was excruciating and I just tried not to move. I felt the familiar fear creep in, but fortunately, I am fully aware by now that the panic attack is just part of my migraine, so I don't let it take over. My stomach hurt, and twice I had to go to the bathroom with bouts of diarrhea. I could feel the buildup, my nausea getting worse, and I actually tried throwing up on my bathroom visits, but it wasn't it just yet. What a nightmare, that's the part I hate the most about my migraines, that peak where my whole body collapses into something crazy and quite violent. I feel restless, but I can't pace back and forth because my head feels like it's about to explode. I just sit in my bed, kicking my legs in the air, if that makes sense. Almost shaking, but not shivering, it is controlled. It just feels like I need to get something out of me. Finally, a stronger wave of diarrhea with a surge of nausea, and I run to the bathroom, sit down for one and then stand up and vomit violently, letting it all out. I absolutely hate vomiting (ok, I guess nobody likes it too much lol). I think this post is getting graphic enough as it is, so I won't get into too many details, but let's just say it put me off grilled meats for a while.

Relief. When I'm done with the vomiting I know it's the end of the acute phase of my episode. Utter relief, in a sense, but also total exhaustion. I will blog more about what it feels like after an acute episode like that next time. Right now, it's time for me to leave.

more about migraines

Did you know that approximately ten percent of the population suffers from migraines? It's not the same for everyone, obviously, with some patients having it far worse than others. I have read about some people who go through daily migraines, although that's a strange way of describing it too, because migraines don't last only a few hours with most people. They usually last anything from 3-4 hours to several days and there are records of migraines that have lasted for a week and longer even! My heart goes out to those of you who suffer from several migraines a week, essentially being affected by this disorder at all times. That is truly a disability. I am sure that such people would find it extremely difficult to hold a job or carry on a relationship, and that's sad. These are the people that truly need to try every treatment there is out there to combat their condition.

Fortunately, these cases are relatively rare, so it seems. Most people have a lesser frequency to their episodes. I have read that the average frequency of episodes is 1.5 a month. In other words, once every three weeks or so. That is pretty much what I am going through myself, albeit a bit less these days then what they used to be several years ago. The length of the episode plays a role, obviously, in determining how long a person is unavailable for participation in everyday life. The official migraine definition talks about episodes which lasts 4-72 hours each. You can do the math here for yourself.

Of course, determining how long an episode lasts really depends on which stages you're counting in. With many patients the early signs can last for a quite a while, even a day or two, and include things like mood changes and overall irritability. Then you have the actual bout of an active migraine, with or without an aura, which I think is what they count there in the 4-72 hours period. For me, and apparently for many other sufferers, there is then the cool-down phase after the episode. While there is no actual pain usually, there is an overall sense of disorientation in various degrees and other neurological symptoms are still apparent.

My First Post!

Welcome to my blogs about migraines. I have suffered from migraines for over a decade now. I have actually made an informational site about it a while ago called Migraine Notes, but I feel that it's time to add a blog as well to this site. I will use this space to blog every now and again about my own migraines, as well as about things that I read about this subject in the news, stories from friends, stuff I read in books. You get the picture ;)

I can't commit to very frequent posts. I think I'll try and post at least after an episode, simply to keep track of things. I only get migraines once every few weeks though, but I hope to be able to blog about them more often… without getting them more often either! I find this to be such a fascinating topic, you know. It really is a whole lot more than just a bad headache. It's a total brainstorm (yeah, funny term, but it really how I feel about it), and since our brain is in charge of our whole body, it can create a variety of symptoms. I have been reading about migraines lately, and I was absolutely baffled by the sheer amount and variety of symptoms that can be part of one of the phases of a migraine.

I will be back to posting soon. I hope you will bookmark my blog and come back often!