Re: MOH some possibly new information. See end of thread. P6

[estre004]

I think what Theresae said is right and what confuses people so much. In my case I get anywhere from 8-12 migraines a month. IF (not true in my case), I was only allowed 6 abortives , that would leave me with 2-6 migraines a month untreated (by the way, I have heard that not treating migraine raising the frequency also). So, should I take more abortives and have no migraines but possibly MOH or take 6 and suffer through 2-6 migraines but no MOH and possibly raise the frequency by not treating them all? I'm just using me as an example. As it is, I am allowed enough abortives to relieve ALL migraines and do not have MOH.

[pen]

"jeselle"]Dear Pen,
I am suprised that your Doctor (GP/or neurologist) is saying that triptans don't cause rebound.

I didnt mean I believe that, it is not what I believe, I was saying I am still being told that.

[Hal]

Anna,

I think if you would stop standing on your head all day, you might have less migraines.

As for MOH, what does MOH stand for? Sounds like it may be drug induced headaches. If that is it, I finally had to get off of Amatriptilyne. One side effect was headaches. Now I am only taking Roxicet for the very bad ones and nothing for the milder ones. I feel as if I am back in the days before I knew there was anything but aspirin for "headaches" and that all headaches are not just headaches.

[pen]

Hi Hal,
It stands for Medication Overuse Headache. It used to be called rebound, but they decided that wasn't quite right.
Actually when it comes to cause, rebound was better. It suggested it was the drugs.
As my husband said MOH really bounces it on to the user and is quite accusative.

P

[estre004]

Hal - I didn't know amytriptiline could cause headaches. I take a small does every night to sleep good. All of my migraines start at night. Interesting. I may stop taking it for awhile and see what happens. It seems most of our medication are catch 22's.

[pen]

Oh Linda, I should have mentioned that. I was on amy. and also nortriptyline and all I got out of them was headaches.
Not migraines and no migraine relief....just morning headaches...

[Hal]

There are alot of side effects to taking amatriptilyne. Some of them are not so nice. One is keeping you in a semi-fog all of the time. You just do not realize how bad it gets 'cause the docs up the dose slowly. When you find yourself signing things you shouldn't, walking into walls and sleeping twelve hours a day, it is time to put the psychotics in the trash.

[pen]

There are alot of side effects to taking amatriptilyne. Some of them are not so nice. One is keeping you in a semi-fog all of the time. You just do not realize how bad it gets 'cause the docs up the dose slowly. When you find yourself signing things you shouldn't, walking into walls and sleeping twelve hours a day, it is time to put the psychotics in the trash.

thank goodness Hal, exactly my experience, and they STILL want me to try it again!!!!!!!!!!!!

[Hal]

Pen,

Just tell them that you are the doctor today and you don't want any more. That they need to try something else. I was in the hospital once and told them to take the IV out, that today I was the doc. They refused until I took out my pocket knife and was going for the tube. I figured if I cut it and squirted blood all over everything it would get their attention. The problem was that those IV's have a back flow valve and it wouldn't have done much.

Hal

[pen]

Wow!!! Go Hal!!!

[Mule Kick]

From the article, that Pen posted a link to:

What about taking painkillers for other conditions?

Medication-overuse headache is much less likely to develop if you take painkillers regularly for other painful conditions such as arthritis. It usually only occurs if you take painkillers or triptans for headaches or migraine. It is not clear why this is so. It may be because people who are already prone to frequent migraine attacks or headaches are the same people who are more prone to getting another type of headache - medication-overuse headache.

(Italics and underlining added by me.)

When I experienced MOH, it was from taking a NSAID - Ibuprofen, by perscription NOT OTC, for Cervicle Spondylosis in my neck and pain in my left foot; but not for migraines or other headaches. I took it three times daily, as perscribed, but it had NO effect whatsoever on the pains that it was supposed to relieve. Instead, about one hour before the next dose was to be taken, I would get a level 4 to 5 HA that was subtly different from a migraine (for one, it was on the opposite side than most migraines). Each dose would mitigate the HA, but then, when the Ibprofen wore off, the HA would return.

I had to bring up the subject of MOH / rebound with my PCP (at that time a PA), who then permitted me to discontinue taking the Ibuprofen; especially since it was not even doing what it was supposed to do. Stopping taking it, once it all cleared my body, allowed the rebound HA to end.

In my experience, the ONLY pain that Ibuprofen has EVER reduced, or ended, was the MOH pain that it CAUSED!

[estre004]

You crack me up Hal. I don't know if it is age or what but I am getting like that. After a car accident in the fall I tried leaving the ER because I had a migraine and didn't want to sit there. They told me I couldn't leave without signing a consent. They turned to get one and I darted out the door.

As for the amitriptaline, I take 25 mg. a night, fall alsleep the minute I hit the pillow, and wake up when the alarm goes off. I wake up refreshed and ready to go. Never has done anything for my migraines (maybe I don't take enough), but it works great for a great night's sleep every time without any after effects.

[pen]

Linda, I got headaches from the Ami from over sleeping, didnt have any effect on the migraines, not even good ones...

[pen]

Found this on Mayo clinic site. They are saying 1% of the population.....
Not sure if that is migraine population or everyone...

http://www.mayoclinic.org/news2008-sct/5128.html

[estre004]

The way I read it, I think it is one percent in the general population. They should have elaborated on whether migraineurs are more prone. It rules me out. When I stop a medication I do it cold turkey--never got a headache from that.

[pen]

I dont "have" to take anything. I take OTC for a pain. I certainly dont feel any need, just give it a try, and if it doesn't work that is it. Same with Triptans. I can relate to any of the things about pain worsening when the med is running out, and definitely dont feel I need to take more and more. In fact now take less than a third of the OTC I took 10 years ago.
My pain just seems to be on some kind of "cycle" and still back to the one and only clue...hormones.

[CluelessKitty]

Medication-overuse headache is much less likely to develop if you take painkillers regularly for other painful conditions such as arthritis. It usually only occurs if you take painkillers or triptans for headaches or migraine. It is not clear why this is so

yeah, right, like I believe that... the body ingest the painkiller, it's processed, then excreted and that's that.
it doesn't care what it is for - a headache, a kneecap, a tummy-ache.

what a bunch of bollocks.


Risa

[estre004]

Risa - I like your common sense way of thinking. I'm with you.

[theresae]

Medication-overuse headache is much less likely to develop if you take painkillers regularly for other painful conditions such as arthritis. It usually only occurs if you take painkillers or triptans for headaches or migraine. It is not clear why this is so

yeah, right, like I believe that... the body ingest the painkiller, it's processed, then excreted and that's that.
it doesn't care what it is for - a headache, a kneecap, a tummy-ache.

what a bunch of bollocks.


Risa

yeah i have often wondered that how on earth does the body know what the med is for!!!


A friend of mine took diclofenic for over 1 year, virtually every day, slow release ones, twice daily for a back complaint, so it was basically in her system all of the time, after eventual surgery she ceased to take them, went cold turkey once her wound had healed and had a fuzzy headaches as she called it for 3 days, then nothing, so if thats the extent of MOH then really its nothing to be concerned about, by the way she never suffered from any headaches when she was taking it daily, never had a feeling of it wearing off and needing the next dose,

she has not gone on to suffer from migraines or continual re-bound headaches, even when she takes the same drug for other complaints,

it was 3 days of a fuzzy head as she called it and then nothing, gone, forgotten, so why are we lead to believe that we will create a cycle of everlasting headaches , it still baffles me as to why it is somehow our fault,

[estre004]

Ditto to Theresae above. I have a neighbor who takes high doses of Ibuprofen everyday for arthritis.
She never has headaches - ever. She skips some days to see if she can get through the day without the pain medication - never a headache.

And if MOH is a few days of mild headache, so what, compared to the relief you got while taking whatever medication you were "over using".

[Chairish1976]

Completely missed this thread before, but yes I definitely have MOH/rebounds pretty bad. The problem is I can't do much about it because the medication works for a few days without a rebound, but if I'm taking something like fiorinal, excedrin, drinking coffee, or similar medicines for more then a few days in a row, I have to stop them for a couple days, regardless of how bad my migraines hit after that. It's been very hard to do because sometimes I'll accept the consequences the day after just to make it go away for a night, if for example I can't sleep because I can try to sleep through the rebound headache the next day instead, and that has worked fairly well. It's one of the main reasons I went on disability leave though, because one migraine can lead to a whole week's worth of rebounds, sleeping whenever I can, and waiting until the storm passes.

[Chairish1976]

Medication-overuse headache is much less likely to develop if you take painkillers regularly for other painful conditions such as arthritis. It usually only occurs if you take painkillers or triptans for headaches or migraine. It is not clear why this is so

yeah, right, like I believe that... the body ingest the painkiller, it's processed, then excreted and that's that.
it doesn't care what it is for - a headache, a kneecap, a tummy-ache.

what a bunch of bollocks.


Risa

Only reason I'm tempted to agree with that info is the fact that there has been some work on how the migraine 'evolves', for lack of a better word, to bypass your body's defenses. Someone I read before talked about the migraine compared to something like our immune system against poisons where the immune system gets stronger and is more able to fight back toxins, the more often it is introduced to it. Apparently migraines might be the same way to certain kinds of medicine. At least I believe it, because every treatment I have, starts to lose it's effectiveness after 2-3 months. So in that way, the body handles it a lot different then a typical headache, backache, etc. It's supposed to be a very different process of pain. Normally, our body only tells us something is hurt so we can do something about it. Migraines are a malfunction in those pain responses - not an actual pain message.

[Chairish1976]

And if MOH is a few days of mild headache, so what, compared to the relief you got while taking whatever medication you were "over using".

That isn't what rebounds are, for me anyway. The headaches and migraines I get on a rebound get progressively more severe, and I get progressively more sick if I stay on the medicine until I face the brunt of the pain/illness for a couple days to let my system lose the tolerance of the drug I am rebounding from.

Edited to reflect this only as my experience. I don't know how the general % of people experience rebounds. Mine are far worse then a normal migraine/headache though, especially since I have to stop taking something for it to make them stop.

[estre004]

Why is it that some get rebounds and others don't?

[pen]

I am guessing it is the same sort of reason some get hooked on alcohol etc.
Something chemical I suppose...

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