Best mix of meds to treat migraine (UK)

[KatherineM_PBC]

Hi All. I read a post a few days ago about the best meds 'cocktail' to get migraine relief - I have read of people going to A+E where they seem to give some intravenous infusion and can we match this. The answers to the other question were mostly from USA I think with drug names I did not recognise so wondered if anyone on the UK side of this forum could comment?

I am very lucky to not get nausea with my migraine, they often start with vertigo or bluring in the right eye, before going into the head pain, last one was on and off for 5 days with a real flare of pain yesterday afternoon, then it seems to have settled down overnight.

I'm sure like many of you I feel I can't go on like this, I take 50mg Amitriptyline daily with Dolovent migraine supplement and CBD oil. I have tried Botox, I have gone gluten free, but still no better (oh weekly acupuncture too!) I don't really don't want to take any more daily meds, it took long enough to wean myself up on the Ami.

So....anyway......what UK drug mix do you find works best for you, ibuprofen and paracetamol together, with Benadryl / Diazepam maybe?

[C_prent]

I’m really sorry to hear about your migraines. Mine are awful too. And like you I have tried so many different things - different medications, natural remedies and supplements, Accupuncture etc

Im British but living temporarily in the USA. Have you tried 900mg aspirin when a migraine starts? My UK neurologist suggested I try it and for some of my migraines it really helps. Im on a similar mix of B2, Magnesium Citrate, Co-Q10, Turmeric. I had to stop taking Feverfew as it affected my sleep. I’m not currently taking a preventative. I also find rizatriptan very useful when a migraine strikes. I was also recently prescribed zolmitriptan for the first time and found it worked. I have heard about people here using sumatriptan as an injectable (I’ve been prescribed it as a nasal spray in the UK for when I have migraine with nausea and it is good for that but gives you a weird taste in your mouth). You could ask you dr to prescribe the injection. Good luck! I hope you find something that works for you

[C_prent in reply to C_prent]

Ps the drugs I mentioned were all prescribed when I was still living in the UK.

[KatherineM_PBC in reply to C_prent]

Hi, thanks for your reply. I bought Anadin at the beginning as someone else told me that Aspirin was better than the other pain killers, but Anadin contains caffeine which I then read might worsen migraine? Perhaps I could just buy Aspirin from the chemist, but still don't think it would do the trick on its own?

I was given Sumatriptan then Rizatriptan but found neither of them relieved the headache but gave me an awful feeling the next day, I was told that Triptans give a rise in Serotonin which will crash the next day, so that must have been what was happening with me so I'm put off taking them now.

I didn't want to go on Amitriptyline but the Headache Clinic said I had to "try something' when I rejected other preventatives. I have tried Botox which didn't help but might now consider GON injections as I'm getting more pain in the neck again!

The search continues...........! x

[MigraineMummy in reply to KatherineM_PBC]

Hi Katherine,

There are 7 different triptans and some work for some people whereas others don't. I would keep trying other ones as they are still the gold star medication in stopping a migraine. And no, it is not true that they always cause a crash. after trialling several I have found the right triptan for me, and I take it at the start of a migraine then continue on with y life. 90% of the time it stops the migraine dead in its tracks and I just feel normal again, absolutely no crash that day or the next day either. Aspirin does work for some people but it's usually not enough to stop a migraine. Regular supermarket aspirin doesn't have caffeine so you could try that because it's the same med as Anadin. In my experience UK A&E departments are rubbish with dealing with a migraine and will not give the meds given in the US. If you are lucky they might give you morphine, but not usually and it often doesn't work. They might aslo try IV diclofenac (it's a strong NSAID like ibuprofen) and they would give metoclopramide (called Reglan in the US) if you're vomiting. The drugs which are commonly used in the US A&E are dihydroergotamine (DHE) which you can only get in specialist treatment centres here for chronic migraine, Toradol (an even stronger NSAID than diclofenac but not available here to my knowledge), prochlorperazine (called Compazine in the US- it's for migraine vomiting ) and sometimes magnesium (yes, the mineral). In the US they also always throw in Benadryl, but it's not the Benadryl sold in the UK. The medication in US Benadryl is diphenhydramine, which is an anti-histamine sold in the UK as Nytol (a sleep aide). I don't think it works for migraine but it certainly can help you sleep one off.

[KatherineM_PBC in reply to MigraineMummy]

Well that's all very interesting, you have a lot of knowledge on the medicines available in UK/USA. Having had a bad experience with Sumatriptan and a terrible experience with Rizatriptan I am too anxious to take any other Triptans, neither aborted the migraine. (Which did you find worked for you?) I hate being a guinea pig for theses drugs and don't find I'm offered any good advice or support from my GP or NHS Neurology. I have paid £110 a time to see a private Headache Clinic too but no further forward. Think I will have to start again and push the GP harder

[MigraineMummy in reply to KatherineM_PBC]

I'm sorry you've had a bad experience with the 2 triptans you tried. I use zolmitriptan nasal spray (I'm one of those who gets extreme nausea so I need the nasal spray to circumvent my digestive system). Some of the other triptans work really well for people who have had bad reactions with others so I would still encourage you to be brave and try. Not sure what you think your GP can do that the neurologists can't, though. There is unfortunately a limited amount of drugs available to prevent or abort migraines. I wouldn't think of yourself as a guinea pig as well. For example, we already know that meds like amitriptyline or propranolol help some people with migraines, but we don't know if it will help you; it's trial and error. Yes, it's very frustrating. But it's what we are stuck with and a neurologist will still be bolder in prescribing than your GP will.

[KatherineM_PBC in reply to MigraineMummy]

The private Headache Clinic prescribed me Zomig nasal spray which I collected on private prescription (£50!!) - it's still in my bedroom drawer as I was scared to take it, they didn't explain it like you, that it is better tolerated than many. What I mean by going back to the GP is that I was referred to NHS Neurology but after 1 consultation I was not given an open ended opportunity to go back but told to go back to my GP if I needed to be referred again. I waited weeks for the original Neurology appt to come through, and by that time I had paid to go to the Headache Clinic who had prescribed Amitriptyline, I was increasing titration very slowly and Neurology just said, continue with that and go back to your GP if you want to see us again. I have better weeks where I think I might be getting on top of things again, then a nasty 5 day attack last week really floored me and has me searching for answers again. My current dilemma is that I am on 50mg Ami - will they suggest I go higher, cos I get really dizzy when I increase titration, or will they suggest I wean off and start another med, and when I wean off will the migraines get worse. There's no easy answers eh?! x

[MigraineMummy in reply to KatherineM_PBC]

Yes there are sadly no easy answers. By the way, SOME triptans are better tolerated but zolmitriptan is not necessarily one of them. Naratriptan, frovatriptan and eletriptan are known as the more gentle ones. Most people who take amitriptyline find it helps some but not all migraines. My advice is that if you think it's helped some, to stick with it but add something else in rather than to come off it. If that's the only preventative you've tried, then propranolol would be the next thing they'd probably give you. It actually makes a good combination with amiriptyline.

[KatherineM_PBC in reply to MigraineMummy]

Propanolol- the Headache Clinic avoided that one as I have a history of depression. They also said that could be why I am more susceptible to the adverse effects of Triptans. See what I mean about not getting good advice, I've been offered 3 Triptans and not the more "gentle ones" considering the history I discussed with the GP/Headache Clinic and Neurology!

[woodlog]

I read this post and it made me feel very sad. All my life, I suffered with this impossible pain, struggling with this and that remedy, years of hospital treatments none of which worked. By sheer chance, I went to my GP with high blood pressure and was prescribed 5 mg Amlodipine. That was on my seventieth birthday. A year later I have had no headaches!!!!!!!!! Nothing that doesn't go with a couple of aspirin. It's like suddenly being given a brand new head, a band new life. What makes me furious is that I've since met a few people who've had the same experience with Amlodipine and on the internet you'll find hundreds of migraine sufferers who have been cured. I tried at least fifty prophylactic treatments over the years, all with horrendous side effects. Why the Migraine Consultancy Mafia refuses to prescribe Amlodipine, an effective drug with no apparent side effects, astounds me. I'd urge everyone with chronic migraine to badger their doctor to let them try the drug for a month. Either they'll never need help again or they'll need to try something else but what's to lose?

[KatherineM_PBC in reply to woodlog]

Hi Woodlog! What a great story. I also looked on the internet and you are right there are some quite recent positive reviews for people who have suffered migraine for years who say they no longer get attacks since having been prescribed Amlodipine.

Throughout my migraine journey I have seen numerous GPs, consultants and clinics and from what I can remember NONE of them have measured my blood pressure. However I had to go to Thyroid clinic this year (I'm hypo-thyroid) and the nurse who took my blood pressure remarked it was normal. I have a GP appt this week so will mention Amlodipine but will she agree to prescribe if I don't have high blood pressure, what is in the drug/what is the drug action that would help migraineurs IF we don't have high blood pressure?

[Bourdonchappy]

Hi, i suffer from basiliar and hemiplegic migraines, and i have been prescribed topiramate for prevention, magnesium sulphate, and nurofen, paracetamol for pain relief. Also, meditation, time to calm my mind every day and quietbtime away from technology. I hope this helps