Medication Overuse

I attended the National Migraine Centre last week, feeling fairly sure that I would be told that I was taking too much medication - namely sumatriptan (Imigran). I was right.

It seems that the best course of action is to go "cold turkey" - just cut out all medication - for a week. By the end of the week, I am told that I can expect a fairly dramatic improvement in the frequency and intensity of my headaches. Wish me luck!

If I don't manage to "stay clean" for a week, there are methods that could help me to cope more easily with the withdrawal symptoms. I won't mention them here as I think they are best discussed with a specialist medical practitioner.

33 Replies

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  • Glad you got to see us. Good luck with the 'cold turkey' it is tough, we appreciate that. A very scary prospect for many, but vital if you are taking too many pills in order to get down to the core headache so that this can be treated in isolation. keep us posted as to your progress.

  • i went cold turkey a few yrs ago and went for 3 months without meds, at the time it was very very hard and having children to look after as well made it difficult.

    it was worth going through the purgatory to clear my head and start afresh with new drugs!!

    i do wish you the very best!!!

  • Hi again Rosianna,

    Can you tell me please what medication you were using before going cold turkey? I'm wondering if I'm going to have to go through purgatory for three months, too! I'm now into my second month and so far, I've not notice much improvement.

  • It find a detox works miracles. I have a real tendency to overuse triptans and find myself needing a detox about once a year. I do it over 6 weeks with the help of naproxen. The first few days are always the worst, but if you can clear your schedule and just accept that you'll be in bed then it's not too bad. It's only terrible when you have to do something or go somewhere...

    Good luck!

  • Thanks for the supportive messages. I'm not into day three and only day one was really bad. I've been told that I can use Naproxen to help me over the worst but I'm trying to do without. So far so good.....

    Thanks again.

  • what is the definition of overuse?

  • I was using too much sumatriptan and the doctor said that more than ten a month is considered to be overuse. I was on a couple of dozen a month! On another occasion, i was told that more than eight days a month of paracetamol is also overusing. I hope this is helpful. :)

  • Thanks !! I had a 5 dayer last week so took one sumitriptan a day !! The most ive taken for one attack

  • i guess you know that if the first sumatriptan doesn't help, a second dose FOR THE SAME HEADACHE is not going to work either. (See the blurb inside the packet!) Sumatriptan works almost every time for me, sometimes killing the headache in as little as 40 minutes. Nothing else can do that! The problem is, a new migraine often starts 12 to 24 hours later.

  • Good luck, you will get through it and I hope you are richly rewarded as a result!

  • good luck :)

    I am lucky as I only suffer for 7/9days as my migraines are hormonal --and (heres the biggy) if I overlap paracetomol and brufen and use metoloperamide I can reduce the intensity of the headaches.....BUT I do have to be very vigilant and recognise the prodrome or this does not work,,, (again, I am lucky as I get a "heads up" as my migraine have a predictable pattern)

    If I miss the first signs on the first attack I seem to have to use the triptans the whole week --almost as if the first one sets the tone for that months session.

    the problem I am struggling with is the dizzy spells which are new and I do not get much of a headache, the only indication is that they are migraine associated is the time they happen, I may be off to the docs to get it checked!!!

    I really hope you find a way to get relief-- keep us posted

  • I am now on daily triptans because my neuro gave me Botox and it has given me daily migraine. I'm not happy about this. But can't stand the pain.

  • Good luck! It was the best thing I ever did and the best advice I ever got.

    I was OKish and holding on unti lthe second week of detox where I had to take naproxin just to give me some relief, I was crying into the sheets of a very dark room for days.

    HOWEVER I was migraine free for three months and it is the most wonderful feeling in the world to wake up without pain. You will NOT regret it.

  • How long did you have to stay on the detox to see any effects please?

  • I'm afraid that I've fallen by the wayside a couple of times - when I have had to drive a long distance or when I have had visitors, so I'm back on sumatriptan again.

    My first week of withdrawal didn't turn out as expected - I had one day of migraine and four days totally free of it but then it came back and hit me hard for three days. I started using Naproxin but had to stop because it gave me unpleasant stomach pains. However, I'm trying again from Thursday when my visitors have left.

  • Hi I just been adviced by the Migraine Clinice to detox from my medication as well mostly sumatriptan and cocodamol, I have tried to prep befor going cold turkey by getting a tens machine and trying meditation. I really hope I can do this as I've been having cluster migranes for over a year now although been a long term mirgianer since I was a teenager I had always managed them reasonably well, as any migraine can be managed that is! It's good to here lots of posative feed back about the reduction of migraines and hope it helps just not looking forward to first mirgaine without and medication.

  • I've now almost reached a week without sumatriptan again. This time, results were as I was led to believe they might be when I visited the Migraine centre. I started the medication-free week with a very intense 14 hour migraine. Since then, I've had a headache every day but much less intense. Maybe, this time, I'm succeeding.

  • Please bear in mind. We all get hit with the medication induced headache theory.

    But where it is of course a problem for some. Others among us just have chronic migraine.

    I have people on my forum who have got off the meds and seen Improvement.

    For some long term. For others the pain returns in a month or so.

    Others get no relief.

    It seems as we are always being told regarding so called preventatives.

    We are all different.

    I hope it works this time surveyor.

    I can't take naproxen. And in any case I haven't yet found anyone for whom it works on migraine. X

  • Thanks for your thoughts, Merrill. In my case, the theory seems to be a reality. Since cutting down on sumatriptan, the migraines have been less frequent (I was getting migraine virtually every day and sometimes twice a day) and, after the initial couple of very unpleasant days, less severe, too. I'd recommend anyone who is taking more than ten sumatriptans a month to try to do without them. As you suggest, everyone is different, but for those of us for whom the condition is severe, any theory is worth a try!

  • Hi surveyor, how is the detox going? Are your migraines improving? I hope you are seeing some improvement. We have spoken before on here so I know you have tried many migraine treatments and preventatives. As I've said before I donot like taking any western meds and I had migraine surgery which helped reduce my migraines by 50 percent. I just wanted to share something with you that I am trying. It's an Ayurvedic herb called ashwagandha , have you tried this ? It is an adaptogenic which basically restores balance to the body, is an anti inflammatory And is used for migraine,anxiety and depression and many other ailments! I have been using these tablets 3x daily for 1 week and have seen an improvement in my daily headaches and not had a migraine yet. ... If you,re interested I can let you know my results in a months time.

  • Hi Julia,

    I guess I've experienced some improvement though not as much as I would have hoped for. For six weeks, I took no triptans or other medication at all but had to break that record when I had visitors or when I had to drive any distance. Having said that, I've cut down my triptan use from about 25 a month to 4 or 5 a month which I think is acceptable. On the whole, I guess I'm feeling much better but I still get several headaches a week some of which are dealt with by using an ice pack and massage and others with the occasional dose of paracetamol or anadin but I'm staying well within the boundaries of over-use.

    I've not heard of ashwagandha but I'll look for it and give it a try. The neurologist I saw at the Migraine Centre suggested that I try amytriptyline again so I've been on a fairly low dose of that for three weeks now. I'll see how it goes. I'd like to give it up, at least for the Christmas period, because I just love a glass of mulled wine and alcohol is a big no-no with amitriptyline!! :)

    Thanks for the advice.

    John

  • HI I would be very interested as my son is currently trying the withdrawal, he was taking solpadeine daily for years for chronic daily headache / migraine, but has been advised this can cause medication overuse headache,

  • Hi John,

    I bought my ashwagandha from holland and Barrett in 300mg tablets. You can take 2/3 tablets 3 times a day but I am currently on 1/2 tablet 3x daily as I felt hyper taking a whole tablet so will build up to this if needed. ... I am a bit of a phobic with pills as well so always go slowly!!

    If you look up on the Internet it says that you cannot drink alcohol with ashwagandha but it says nothing on the bottle and I had a couple of drinks the other night with no ill effects. ( I too like a mulled wine at Christmas, infact I bought a bottle today :) ) we have to have some vices in life!

  • Hi, me again! Meant to leave you quite an interesting link for Ayurvedic medicine should you decide to give it a go

    Www.herbslist.net/ashwagandha.HTML

    Best wishes

  • Thanks. I ordered some from Amazon.

  • Hi John, I just thought I,d give you an update on my ashwagandha experiment. I took the tablets for just over a week with no headaches but they started to make me feel hyper, almost drunk! Anyway I stopped taking them and got the most horrendous headache that lasted four days so guess they were working but giving me side effects that I didn't like. I am looking into an alternative or maybe combining it with a calming herb to counteract the buzz! You may react differently as we all do to all medicine but thought I,d let you know my experience. I,ll keep you informed of whether I come up with a magic formula :)

  • Hi Julia: You

    make me wonder whether I should try ashwagandha or not. What kind of dose did you take? Did you start on the minimum and build up and when you stopped did you reduce the dose gradually? I've been on amitriptyline but I'm gradually weaning myself off so that I can try Ashwagandha.

  • Hi John,

    I was taking half of a 300mg tablet every four hours. This is much lower than the dose you can take but I wanted to start gradually to see what side effects I had. I reduced it in a couple of days by taking just 2x half tablet per day,then stopped. I think that maybe I chose the wrong herb for me as I have read that if ashwagandha makes you jittery then it's likely to be the wrong herb for you. That said I see no reason for you not to try it as you may react differently. Its a tricky one as these medicines are new to me too.I have started on Gotu Kola yesterday which is another Ayurvedic herb supposedly good for migraine, this is another adaptogenic herb but has cooling properties. It again is used for mood disorders, epilepsy and blood pressure problems so guess that's why it's used for migraine just like the western equivalents. I will try this herb out and keep you posted of the side effects/effectiveness for migraine if that would be helpful. If you do decide to try the ashwagandha I do hope it works for you.

  • Hi John,

    I have another interesting link for you to look at should you wish to try the Ayurvedic medicine.

    Www.ayushveda.com/health/migraine.htm

    Hope you find this useful.( some of the names of the medicine have different names here but if you google them they come up with the uk version)

    Julia

  • Thanks. I've had a look at the website. None of the three types of migraine matches mine so I have doubts that the treatments would be of help to me. Over the years, I've tried cutting out of my diet most if not all of the things listed on the site but again, without success.

    Anyway, thanks again.

  • Good luck with whatever route you try for your migraines, I will let you know if I find something that works. We are all on what feels like an impossible mission sometimes !!

  • Hi. Your experiences make me think maybe I don't suffer form medication overuse. I tried a detox with naproxen and I didn't feel naproxen gave any relief at all. Then after my detox things got worse and I started to take even more triptans than before. As for the cold turkey, I was given a sheet wth a graph, it was a study showing the results long term and it showed that it was best to go with naproxen than cold turkey.

    Some of you mentionned some supplements, I don't believe in cheap ones form places like Holland and Barrets, only in purer organic ones, like biocare for instance.

    Hope you are getting there John.

  • Naproxen didn't help me either although I possibly didn't try it for long enough. I had to stop using it because it played havoc with my stomach.

    I'm still struggling to keep my intake of sumatriptan down to 10 a month and am trying amitriptyline again but I hate the side effects and so far it's given me no relief. I still don't know how much I should take before I'm supposed to notice any benefit from it.

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