I know there are a few migraine sufferers on here – and I would appreciate some anecdotal feedback, please.

I’ve suffered with migraines for years, but they have been getting worse in recent years – worse in-terms of frequency, rather than severity or intensity. My migraines are debilitating because I do a thinking job, but I don’t have to do the darkened room thing.

I’m now in a place where for about 18 months my longest clear streak has been 9 days – and the exhaustion is real. Even on clear days now, I can tell where the headaches have been (if that makes sense).

I used to be able to manage my triggers, but now I’m so deep in a hole that feels too hard – and I’m not sure my old triggers are my current triggers.

Current meds: Low does amitriptyline and triptans during attacks. Triptans are now the only thing that works during an attack – all other meds seem redundant (Anadin Extra, Migraleve etc).

I’m thinking of speaking to my GP about starting on a course of prophylaxis meds to try to get in front of my headaches and get some energy/health back.

Some questions, please:
* What have you taken and has it worked?
* What about side effects or downsides?
* Any leftfield options that you have tried and found useful?
* Is it possible to train/exercise hard when taking prophylaxis meds? (I’m supposed to ride Lejog in 22).
* Any other thoughts or wisdom to share?

Thanks!

I don’t suffer so regularly now but I found the best short-term relief was to do some hard exercise. I’d walk up a hill, ride, run etc and while doing that the pain would disappear. It would return though.

Luckily(?) the painful part of my migraines would only last 24 hours or so, the after-effects of slow/slurred speech, nausea etc would drag on for another 36 hours.

I haven’t found any drug that completely worked, so just learned to manage with Migraleve or similar.

GP and migraine sufferer here.

At present I only use “as needed treatment” – sumatriptan 50mg. Seems to work. THankfully, I don’t get frequent enough migraines to contemplate the prophylactics.
However, I HAVE had Botox treatment in my forehead which REALLY helps with migraines and tension headaches – I’m a big ‘frowner’ and I really can feel the tension in my forehead, which in turn leads to headaches and migraines. The Botox DOES work (for me), and thinking about it, I should get more as it’s been months since my last go.
I’m not fussed about having a wrinkle free forehead AT ALL! But it does help, and is a known treatment for migraines.

I personally WOULDN’T take propranlol – it’s effective, but my resting HR is about 40, and i’m sure it’ll drain me.

Amitryptylline is a reasonable option – take it at night. A bit sedating.

TBH, those are your best first line optins to discuss.

DrP

I know 2021 has a pretty poor reputation, but for me at least it’s the first year since I was a teenager that I haven’t had regular migraines. What’s changed? We had a huge snow storm here back in January that left most of the shops shut for a few days, and we ran out of coffee… I decided to make the most of this opportunity and eliminated caffeine from my diet. I’m also making sure I get at least 7 hours sleep a night – previously I’d often get 6-6:30 hours, and then get through the day drinking strong coffee to keep me alert.

Not exactly the answer to your question, but if circumstances allow I’d definitely give it a try.

Thanks – some good thoughts there.

@ DrP – I assume any high intensity exercise is out if you are on beta blockers?

For me, although I’m fortunate they’re rare now, cocodamol, food sweet and good old sleep.

@menothim

Normally a ‘milder’ b blocker is used, propranolol. However, they work by limiting heart rate, so you may find your ‘rev limiter’ is capped if you take them.
Additionally, a v low resting heart rate would make me v wary of prescribing/taking them.

DrP

To counter DrP I spoke to a patient yesterday whose life has been immeasurably improved by propranolol. From 2-3 migraines a week to less than one a month. She’s not into regular high intensity exercise though so that does need to be taken into account.
My daughter also takes them but the thing that has prevented her migraines was leaving home to move in with her boyfriend and starting her uni masters. So “living with parents’ appeared to be her trigger.

To counter DrP I spoke to a patient yesterday whose life has been immeasurably improved by propranolol. From 2-3 migraines a week to less than one a month. She’s not into regular high intensity exercise though so that does need to be taken into account.

Apologies, I may not have made myself clear… I agree propranolol can be really successful, and I’ve used it in lots of patients also with good outcomes.
I guess I was highlighting for ME I wouldn’t consider it..

DrP

Jesus H Corbett, you have my sympathies. I’ve had two bouts of migraines in my life and they’re not something I’d wish on my worst enemy, anyone who thinks they’re a “bad headache” has never had one.

For me the only thing that dented them was Imigran taken early enough but, you’ve already done that.

Good luck.

As a teenager I was prescribed, I think, Sanomigran (that might not be the correct name). It seemed to work back then. I rarely have an attack now, when it happens its usually horrific pain, but fortunately far less frequent. I’m intrigued by the Botox method mentioned above as I am too a frowner, and certainly tension headaches are the most common pre-cursor for a migraine these days.

My wife tried all sorts of medication and some would work for a while some not at all and while she still has to fall back on sumatriptan, BOTOX has been a game changer for her. It’s honestly helped her back to a normal(ish) life and allowed her to be active enough to lose weight and regain fitness. She has quarterly treatments around the head and neck and it basically prevents a lot of migraines even starting. She’s just commented she had to have had 3 failed preventatives before being referred for BOTOX.

There’s also CGRP but that’s very much a last resort thing due to cost.

Good luck.

FYI..you’re probably very unliekly to qualify for Botox on the NHS in most areas..

You’re better off going to pay for it.. it’s about £180 for the forehead areas.

DrP

PS..whilst there, I got my boobs done too…lovely they are now… Just saving up for my trout pout lips…