Migraine Headaches Support Group

In my experience, you've hit it right on the nose. Imitrex and the other drugs can really lose their punch if taken real frequently.

Imitrex only worked once for me. It was blissful experience that one time it did work, but alas, it was only a one time good deal. No one can explain why it only worked that one time and never again, despite the fact all of my migraines (and they are true migraines, not some other type of headache) have the type of onset, same presentation, same duration (usually multiple days), etc.

As for the Topamax, how long have you been on it? It takes a couple of months for the preventive effect of Topamax to actually kick in; it's not an overnight or even couple of week deal. You're on the standard migraine preventive dose; most studies show minimal additional positive effect at a higher dose, but do show signficantly higher side effects if you go about the 100 mg in a split dose, so please be sure to have a long conversation with your neurologist before making a decision to raise that Topamax dose. And keep in mind that like all medications, it simply doesnt work for everyone.

But for now, do talk with your doctor for two reasons.

The first is your current condition, the endless migraine that won't stop. This is often called status migrainosus and is a potentially very serious condition. Medical intervention is needed to break the migraine cycle and your rescue medication isn't going to do it. Often steroid step down packs are used to subdue the inflammation around the nerves and calm them enough to end the pain.

The second is to talk about a different rescue/abortive medication. There's no need for you to continue to be in pain once that migraine breaks and the next one hits if Imitrex is no longer working. There are so many options for rescue medications now that certainly there is one that will work for you.

But please, do make a phone call to your doctor soon. Any change in a headache that is so dramatic such as yours needs immediate medical attention. It's one thing to get more frequent migraines, but when the pain never stops, there's something else going on that needs urgent medical care.

Give your doctor a call and emphasize the all day, every day, THIS IS A NEW AND VERY DIFFERENT HEADACHE (use those words; it get their attention). And if this now the worst headache of your life, go to the emergency room and tell them those exact words, THIS IS THE WORST HEADACHE OF MY LIFE. They will listen, and they will treat you, very quickly.

And please, let us know how you're doing.

Imitrex worked really well for me for about 2 years, then worked less and less to the point where it didn't help at all. About 7 years ago I was switched to Zomig (another triptan) and it has been a godsend. One dose always does the job and in all these years its never lost its effectiveness. My only problem is that like all triptans it can only be prescribed in limited quantities because of the cardiovascular risks, so while my insurance will only cover 16 a month, I take at lease 25 a month. I'm fortunate that my doctor gives me samples to fill the gap.

Actually, you are where I am right now in the migraine cycle that is completely continuous – I had to drop out of this semester of college because I cannot function, think, or drive. I was hospitalized twice for this migraine – the first time they gave me strong narcotics which just knocked the pain down to a 3 or 4, and then the rebound migraine was even worse. That was the second time I went in where they used a different combination of non narcotic drugs. It still didn’t break the cycle, and this has been going on for three weeks so I feel your pain. Call your doctor; you need to find some treatment that will work – and like ihavepkd said tell him that “This is a new and very different headache”. Good Luck!

I ended up calling the doc before I got the advice from anyone but daninflorida, so when the receptionist at the doc's office asked why I wanted to come in, I stupidly said "headaches." She scheduled me for this Thursday. I wanted to cry.

I ended up going to the ER on Monday night. The doc there gave me an iv of toradol and compazine, which helped. They also did a ct, which I hadn't had done at all before, so that calmed my worries that something more life-threatening was happening.

He also sent me home with rx's for fioricet and phenergan and a gentle suggestion to see a neurologist. So far, the fioricet is relieving the pain, as long as I take the max prescribed dose at four hour intervals. It isn't a substitute for triptan-type relief, though, right? I'm thinking I should just try to take the fioricet only (and not anything else) until I can talk to my doc tomorrow and see if we can try a different dose of Imitrex or a different abortive med. I guess I just feel sort of lost about all of it.

I did get a break of most of yesterday morning before the headache settled back in, and I was grateful for that. Do you all ever feel like that? Like it doesn't necessarily hurt yet, and you don't really have any visual or physical aura you can point to, but you know the pain is there, waiting?

As far as the topamax goes, I've only been on it for about three weeks, so I've got a long way to go till we see if it will help me or not. I've been delayed in trying topamax (and most meds) because I was still a nursing mama until recently. I wonder sometimes if putting off starting medications sort of made things slide downhill faster for me.

Thank you all so much

Migrainemomof3,

I am so sorry to hear that you had to go to the ER, it is really tough when the docs or even nurses don’t listen. You listed the combo the ER docs put me on the second time, only they added Benadryl because they said it helped with inflammation and to break the cycle. It worked for 24 hrs - I am just having a hard time, and my neurologist that I’m seeing for the second time isn’t listening to “this doesn’t work and it’s on week three of migraine cycle” – you’re not alone! I’ve been on Fioricet since I was 17, it really works but I found for myself it works the best when added to Mobic (maybe you could ask about a non steroidal anti-inflammatory med could compliment the Fioricet if the Toradol worked.)I will tell you that if you take the max amount of Fioricet, you can either get rebound migraines or your body can become accustomed to the Fioricet. This has happened to me before, it happens really quickly too - I know you are in a lot of pain I just wanted you to know what I’ve experienced from this medication. I had this great break from the migraine today, it really was fantastic and gives me hope, but I can feel the migraine starting back up. I know what you are talking about when you say the pain is there waiting, even on this short break I feel it very faintly in the background of my daily activities. Usually the Fioricet nixes really bad migraines if I keep on it for three days (I only take one – two if it is really bad – I find if I know its going to be a bad one and I can knock it out with the max strength meds then I usually am set to go over the next few days – I just have to watch what I eat and how my body feels, so I do not push it) I really hope they find something to break your cycle, it is very hard to go through daily life in constant pain like you are.

Best Wishes!