Medication overuse. Days not dose

HI there,

Just wanted to a make a point of meds overuse from a lovely consultant I saw two weeks ago.

You may already know, but just in case (after ten years of migraines I never knew).

She said med overuse is about the days you take not the dose.

So, if you take a tablet on day one and then it lingers and you don't want to take another, but get to the next day still feeling awful, you the decide to take another ( I have done this myself in fear of taking too many all at once). The headache may come and go or linger, but there is a chance is may come back the next day and so you take another tablet.

What the consultant is saying is that you should strike while the iron is hot and kill the headache in the first instance there and then, despite the large volume of meds you may take for it. She said to take three soluble aspirin with ordinary coke to try to kill off the headache (I already knew this and sometimes it works and sometimes not). Then if after 40 mins it hasn't died off, take a triptan. And another in two hours if still lingering.

That, she is saying, is not medication overuse. But taking meds over a certain number of days is.

So always try to kill of the headache with as much as you can throw at it in the first instance.

I think I have suffered in the past with meds overuse and see a lot of comments on here about it so wanted to pass the info on.

Happy to hear your thoughts if you think otherwise!


29 Replies

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  • Have heard about the aspirin coke combo but not sure I could actually drink coke with all that sugar...wonder if the sugar free works!

  • it should do because it's actually about combining asprin with caffeine - though you can also buy asprin with caffeine and there are plenty of other drinks that contain caffeine.

  • No,with me, it only works with the genuine Coca Cola.

    Just a few sips at a time, is enough, I never drink the stuff normally.

  • I was told original coke initially by another consultant but this consultant said a 'fizzy drink'.

  • Interesting, that's useful to hear. Mine go on and on, I've never ever managed to knock one out quickly and I try not to take more meds. But sometimes have to even though they only take the edge off the pain.

    If only I could take large doses of aspirin, but it makes me ill, once threw up blood. Ibuprofen worse. Tried triptan but was what you describe, took ages to work and headache just came back again.

  • Perhaps injections may work better for you than tablets?

  • designer111 you maywell be right, Injections probably would work better than tablets, but I do have a concern about triptans and stroke/cardiac issues as I've had many strange neuro incidents (probably "just" migraine but impossible to know for sure). And I think a fast acting triptan would be more likely to trigger this. Happy to be wrong though as it would be a great solution. There's also a nasal spray available.

    I asked a neurologist about the injections when he told me to take triptans (dismissed stroke concerns as irrelevant as he said triptans are "statistically safe") but he wanted me to take the tablets. Despite the fact that I had accompanying gastric issues as many of us do making it impossible to absorb the tablets properly.

    I've just found out that each triptan injection costs over ยฃ20 so an expensive option for NHS. Maybe the reason the neurologist was reluctant.

  • My consultant recommends Domperidome to take with triptans which I believe stop the feeling of nausea and help to stop the acidity of the tablets in the stomach.

  • Personally, whilst there may be some truth I'd be really wary about overdoing it on the triptans - an overdose of triptans is quite easy and it is an extremely unpleasant thing - and can make a migraine worse.

    My headaches used to be really bad but I've never taken a whole wafer of rizatriptan - I'd generally take somewhere between 1/4 and 1/2 at that point in time - I was getting through about one pack a month at that point - but GPs assumed that it was OK because that meant I was only taking it on 6 days presumably. Don't think they are aware that you can actually break triptans into smaller doses.

    I saw a hormonal migraine specialist and he was really into the idea of not taking a whole tablet - though it came from my mother who used an ergotamine and used to break that down into smaller doses - so I'd done that and when I switched to triptans I started doing the same. I don't get the migraines so often now but I certainly wouldn't consider taking anything like a full wafer in one go - infact I'm down to 1/8th of a wafer and it seems to work well.

  • Sorry another thought -

    Asprin is an NSAID (non-steroid anti-inflamatory drug) as is ibuprofen and a whole load of other over the counter pain-killers.

    NSAIDs aren't recommended in combination with triptans because they can make them less effective. Not sure anyone is entirely clear how triptans work with migraines but one theory is that it is because they are vaso-constrictors and so cause blood vessels in the brain to contract relieving some of the pressure that may be the cause of the headache. NSAIDs will have the opposite effect.

  • I used to break the tablet in half, but now it wont touch the sides, so I have to do whole. Interested in a hormonal migraine specialist. I think that may be reason behind mine. Can you tell me anything more about it? Thanks

  • you would need to ask for a referral from your GP - the one I was seeing retired a number of years ago. Possible that there may not be one in your area - other thing to try is contacting the National Migraine Centre and see if they know of anyone in your area.

  • I have recently been seeing the National Migraine Centre in London following 2 hospital admissions in 3 weeks with migraines so severe I passed out. I am 47 and have had migraines for 40 years. They too discussed medication overload and also the use of soluble aspirin when an attack starts. They set up a plan for me to follow and I was doing really well but ended up in hospital again on Monday when I passed out again due to the pain being so severe!! The consultant in hospital gave me a triptan subcutaneous injection which worked wonders!!! He has told me to see my GP about getting some so I can inject myself if I have a severe attack ... He was not sure if this was possible .... Does anyone else have injections at home?

  • I have a friend who was certainly part of a trial with a migraine drug that she has to inject - think she still uses it and does it herself. Subcutaneous injection is relatively low risk - diabetics did it for years though I think people are now being switched to pens ... but basically it is still the same - so think it should be okay.

    Best of luck

  • Hi Niki i have these at home, their like an epi pen. You just load it up and shoot ๐Ÿ˜ƒ i wouldn't survive without them . Your GP should be able to prescribe them.๐Ÿ˜ƒ

  • Thank you! I am seeing my GP on Wednesday so fingers crossed. The A&E consultant was going to write to say that I should have them. On this 3rd admission he gave me a triptan injection and within 20 minutes I felt like a new woman!!! I would only need to use one if it became really severe as normally my triptan tablets help.

  • Yeah you get to learn when the injection should be the choice of weapon ๐Ÿ˜ƒ

    I get 4 a month on repeat but use 2 a month if I'm lucky, tablets usually do the trick.

    Hope your GP helps ๐Ÿ˜ƒ

  • Niki have you had botox yet? My friend used to pass out with hers and botox worked for her

    Didn't do anything for me 3 times but might stop yours ๐Ÿ˜ƒ

  • I am considering it at the moment! Never felt so scared and vulnerable as I did on Tuesday. I tend to have a really good pain threshold but this was awful. To wake up on my bathroom floor having been sick and incontinent if urine was so distressing. Just don't ever want to be in that position again :-(

  • Awe god ๐Ÿ˜ญ i would take the botox route. I too have a very high pain threshold and i didn't feel any of the injections but some people find them really painful.

    I didn't feel GON blocks either? Actually thought something must be wrong with me or they were doing it wrong ๐Ÿ˜ƒ but neurology said my pain threshold was high. Nothing they done to me would be worse than the pain i was in at that particular time ๐Ÿ˜ƒ

  • God sorry to hear all your troubles Nicki!

  • I use the sumatriptan injection regularly. It works well and is easy to use ( it's a preloaded pen)

    By the way my migraine specialist said it is a good idea to use a large dose of NSAID at the onset of migraine with a triptans and anti sickness drug.

    Seems like advice we are given varies a lot !

  • Hey KateeB...yeah me too. Both neurologist advise 900 soluable asprin and triptan.

    Every admission to hospital they instantly give me 900 asprin and triptan. ๐Ÿ˜•

  • Yes agree! She said try the aspirin and coke first and if still lingering then have a triptan. If still persisting, another triptan 2 hours later. Would like to use the pen for sure.

  • I have to take my meds with food or they won't work. If it's a really bad one I take an anti nausea drug and sleep it off. And then there are the ones that keep coming back, usually in January, and I have no idea what is going on there.

  • I hit it with 1/2 tsp of salt in a cup of just boiled water plus a water bottle (or 2 - of cold water I keep in the fridge for just such an emergency) & a strong cup of strong coffee with full fat cream. SUgar is an accelerant for throwing gas on a fire (the migraine is the fire, and the sugar is the 'gas' that makes it explode). I know people who don't drink coffee who do the hot salty water & cold water & whole milk with the same great results!! I no longer take ANY meds or eat any sugar or gluten and am relatively migraine free..just a bad night sleep or weather remains to be my trigger - food was my biggest issue (who knew raw tomatoes are a common trigger???!!!).

  • I read about the Epsom salts and warm water and to down it in one. Made me feel so sick on top of my existing headache. Didn't seem to work!

  • Epsom salts are for the bath..not to swallow, I am sorry you got sick :(. The salt to mix in hot water is table salt.

  • I think I've confused with Himilayan salt. You should have that with coconut water apparently.

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