I’ve suffered from headaches since my preteen years. I learned about medication overuse headaches the hard way as a teenager. Back then there was nothing to take for headaches other than Aspirin or Tylenol.
Over the years the headaches became less frequent and less severe (not counting the self-induced ones, particularly during my university years), so I didn’t worry about them.
But as I moved into my 40s they got worse again. During the last couple of years they became a real disability, causing significant lost work time and productivity.
Strangely, I could never figure out what type of headaches they were, as none of the conventional descriptions fit. After a long series of tests and trips to doctors I was diagnosed with atypical migraines. Atypical because I usually feel them on both sides, and don’t usually feel nauseated or bothered by bright lights. Just debilitating pain. At its worst I have trouble even comprehending what people are saying to me.
The first step in getting a handle on headaches was to start a diary. I was pointed to the headache diary and pain scale available from the Headache Network Canada. These are downloadable PDFs, and there is also a sample diary page showing how to fill one out.
After three months I had enough diary information to show my doctor that I had a serious problem. We began experimenting with different medications. He also referred me to a special headache program available here in Calgary, the Calgary Headache Assessment & Management Program (CHAMP). I qualified because I had more than ten days per month of at least partial disability.
The CHAMP specialists provide the latest information on migraines and other types of headaches. They also provide a variety of self-help sessions. There is much more we can do to manage our own headaches than most people realize. The areas covered include:
- Posture and ergonomics
- Trigger management
- Stress management
- Sleep quality
Of course, many of these are things we all need to work on. But for migraine sufferers they are particularly important, as they have a much bigger impact on quality of life.
Two classes of medication are involved in treating migraines: acute and preventive.
Acute medications are the ones used to treat a headache. These should be taken at the first sign of an impending migraine. Most people tend to wait it out and only take the medication when the headache gets bad. This is exactly the wrong thing to do. In some cases it makes the medication completely ineffective.
There are the over-the-counter painkillers that can be used for any type of headache. But these are often ineffective against severe migraines.
I’ve had some success with Arthrotec, which combines the painkiller Diclofenac with another medication designed to reduce stomach irritation. It gives me intestinal cramps, especially if I take more than one, but it’s worth it to minimize or avoid a migraine.
For migraines in particular, there are also the Triptans and Ergots. I reacted badly to the first three triptans I tried (severe muscle weakness), but finally found one that worked well for me without serious side effects: Axert.
Preventive medications are ones that are taken on a regular basis to reduce headache frequency and severity. These fall into several categories:
- Certain blood pressure agents (e.g. propranolol, Verapamil, candesarten)
- Certain antidepressants (amitryptaline, nortryptyline, venlefaxine)
- Certain anti-seizure medications (valproic acid, Topamax, gabapentin)
- Others (Sandomigran, flunarazine)
Some of these may be ruled out, depending on other medical conditions or drug interactions. For example, asthmatics should not take propranolol.
In my case, nortryptyline has really helped me, significantly reducing both the frequency and severity of my headaches with minimal side effects.
Recent research has pointed to a number of supplements that may also help. While the research is not conclusive, they are all generally safe in the suggested dosages. They may benefit you in other ways as well, and the worst case is you waste some money. They’re certainly worth a try if you have a serious migraine problem.
Here is the recipe the CHAMP specialist gave me:
- Magnesium 500mg daily
- Vitamin B2 (Riboflavin) 400mg daily
- Vitamin D 2,000IU (50mcg) daily
- CoQ10 300mg daily
- Feverfew 250mg daily
That amount of magnesium can interfere with calcium absorption, so don’t take it at the same time as calcium supplements or other dietary calcium sources. Magnesium can also help you sleep, so it’s best to take it at bed time.
The other should be spread out through the day. I usually take them in two doses after meals.
The combined effect of:
- the migraineur’s cocktail,
- the nortryptaline,
- carefully managing my triggers (avoiding chocolate, red wine and overexertion, and getting enough sleep each night and on a fairly consistent schedule), and
- lifestyle changes (losing weight, lowering my blood pressure and getting enough exercise)
has cut my headaches from more than 10 days per month with an average pain level of 6-7 out of 10 down to about 3 days per month with average pain of 3-4. At this point I’ve stopped keeping my diary because my headaches are not a serious problem anymore.
Your mileage may vary of course. But I highly recommend you try some of these if you suffer from migraines.
Please let me know what you think.
- Massage Therapy Relieves Tension Headaches (massageenvy.com)
- Migraine Diary Form (justamigrainediary.wordpress.com)
- Are Allergies Causing Your Migraines? (everydayhealth.com)
- Medications for Headache Relief (everydayhealth.com)
- What Is a Rebound Headache? (everydayhealth.com)
- How To Treat A Migraineur (momaftergodsheart.wordpress.com)
- Migraine 101: Menstural Migraine (somebodyhealme.dianalee.net)
- Severe headaches tied to suicide attempts (thehandiestone.typepad.com)
- Migraine or Sinus Headache: What’s the Difference (webmd.com)