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.