Taking triptans on consecutive days.

Was told yesterday that if you take triptans two or three days in a row, they dont work.
Or work a lot less.

Is this what you all have been told?
Is this your experience please?

Thanks.
Pen

I've not heard of that and I know we have a member here that uses them daily. I think the concern would be that they would "burn out" and stop being helpful if you use them too often. But 2-3 days in a row I don't think would cause a problem as long as you aren't doing it all the time.

I know that they can stop being effective but in my experience that has nothing to do with usage.

Thanks Becky, sure hope you are right.
I dont want to take the damn things at all, but I have nothing else.

I think they are not hitting it because this neck pain is not migraine.
But what do I know?

P

i read somewhere, way back, that if one alternates drugs (does not take the same drug on consecutive days) one is less likely to become tolerant. i.e.: it quits working.

that's what i've been doing for years and years, with the two triptans which work for me. pen, do you have a second one that works? my primary doctor seems to agree that this is a wise plan.

i do it with my sleeping drugs, (antihistamines) also. never take the same one two nights in a row. i'm certainly not saying this will prevent tolerance, but one hopes it's a lot less likely.....dianne

I dont dianne no. I have taken them on 3 consecutive days several time (reluctantly).
Not had any problem with the efficacy of them.

I do think it is this other pain.
Neck, back teeth, no nausea, nothing, just lousy pain.
Nerve pain, dont know.

Tried other NSAIDS and things, but nothing touches this other pain.

Thanks Dianne.

A quick one - computer and head crashing

As you know I take far too many, often on several consecutive days and they don't generally lose their efficacy (is that the word?).

Liz

Indeed it is the word Liz and thank you for that.
Hope you feel better very soon.

Pen
PS: How many do you take....not so many ....

Pen,

All I've ever been told is not to take more than 2 in any 24 hour period.

I have never taken 2 in any 24 hour period.
Most I have done is 3 in 72 hours, and more often 2 in 48 hours.
Usually it is 1 in 48 hours, but depends on the migraine.

Latest caution was not more than 8 or 9 a month.
That's pretty pants...

P

Would be really good if "they" could make up their minds.....

Right hand doesn't know what the left hand's doing!

I know. My neuro gave me 12. He said it was okay to take them all and keep off the OTC.
Last time I saw him, last month, he pulled a face when i said I take about 10 a month.
I do usually but last month it was the whole 12....no idea why...
Then when I spoke to the Migraine support they said their medical advisory board said no more than 8 or 9 or risk of our old friend MOH and also lack of effect....

G R E A T !!!!!!

My new neuro told me not to take more than 2 in a 24 hour period, and no more than 2 days a week. I keep asking her what I should do the other 5 days a week when I'm suffering. She just says "our goal is to get you to no more than 2 migraines a week." Umm that's great, but it's not happening after 6 months. Thankfully, up until now my GP has given me rescue meds to use when I need them, but I heard from his nurse that he's thinking about not doing it anymore because of the neuro's suggestion. However, I told him my concern about not having proper pain control when he asked me to try this neuro. He PROMISED me he wouldn't let me hanging in pain and no relief. I guess he forgot or changed his mind. I e-mailed him asking what to do, but haven't heard back yet.

Pen,

I've heard so many different versions of how often it's 'safe', whatever that means, to take triptans. I finally decided that I'd take them when I need them. The anxiety of trying to figure it all out was triggering more migraines. When I stopped worrying about it and just took the pills, I had less migraines.

Chris

Chris,
I am getting to that too. I have enough anxiety as it is. I don't know what to believe...well seems none of us do.
I just know when I hurt, I hurt bad and I have to try. Usually they work pretty well in 2/3 hours and that is quite long enough to try to deal with the pain. Lately I seem to be having a bad spell (well I hope that is all it is). Just cant get more than a couple of days before the beast is back. So I have taken more. So far two of them have been disappointing (out of 12 last month).
But the vestige of the pain has been in the right side of my neck, or back of my head. Yesterday my daughter shifted it for me with head massage. This other pain can also abate all by itself but migraine will only get worse. So I have to take them.
I dont know why I am still agonising over them, except the amount I suppose. Chris how many do you take before you either feel it is excessive or in danger of running out

Brenda,
I have been there too. When my usual GP was on long term sick last year, I had to see one of the others in the practice.
He took my 12 a month and reduced me to 6. I told him that was cruel and what was I supposed to do. He gave me amitryptiline. I did try to tell him I had already been there and they were no help. He got really unpleasant with me and told me to go and see my usual GP......I left, and managed to get an appointment with another one at the practice the following week.
She gave me back my 6 and added 6 on. So now I get 18. I have never taken more than 12. But no way could I manage on 6.
I used to agonise when that was all I had. "How bad is this migraine? Do I take a triptan, or should I wait because the next one might be worse and then I might not have enough." What a way to live.
Hope you get it sorted Brenda.

pen wrote:Chris,

I dont know why I am still agonising over them, except the amount I suppose. Chris how many do you take before you either feel it is excessive or in danger of running out?

I am talking about before the cayenne, which is overall working pretty well for me as a preventative. OK, my triptan is Maxalt-mlt. It's the type that melts under the tongue. It's very effective for me and has started to lift the pain in as little as a few minutes. The migraine, including the nausea is usually completely gone within an hour. I take a pill as soon as I feel one coming on. I used to agonize over the process, telling myself, "Maybe it won't be a migraine this time or maybe it won't be so bad." Truth is it's always a migraine and it's always that bad. So when I first feel the tinge, I take a pill. I find the pills work better and faster if taken at the start of a migraine. If I wait, I may have to take 2 pills to overcome the beast.

I am much happier and have more pain free days after I stopped fighting with myself about taking the Maxalt. Well, what if I run out of pills and need one before I can get my next prescription? I stopped playing "what if?" with myself. I just decided that if I ran out, I would deal with it at the time. I have only run out once in a several year period. I was able to secure Maxalt samples from a nurse friend who understands the problem.

I would not ask her for such a favor unless I am desperate. Because of my restraint, she will help me. But if I didn't know her, I would figure out another way. Like I said, I don't worry about it and I'm a lot better off.

For years, my insurance company only allowed 9 a month. Then without notice, they increased it to 12. I don't know why and I didn't want to rock the boat. I rarely have had to use 12 in a month.

The most I have ever taken in a 7 day period is 7, one per day. The most I have ever taken in a 24 hour period is 3. Since I have had no more success in getting a straight answer about how many and how often, I crafted my own rules. I will not surpass 3 in a 24 hour period or 7 in a 7 day period, whichever comes first. So far that's worked well for me but I wouldn't suggest it to anyone else, because I really don't know what is correct.

Chris

I asked my neuro about this, and he said to treat all migraines with Maxalt. Said to stop stressing. Of course, I am needing less than the 12 per month allowed by insurance, but that is a whole other issue.

Hi there,
Well that is encouraging. Stop stressing. I wish I could hear that from mine.
All I get is warnings about, too many....rebound....lack of efficacy.

I assume this has helped you?
P

Yes, lots. I have posted recently about my success with a new preventative, Lisinopril, which has cut my migraines down from 2-3 per week to about 4-6 a month. I was at my wit's end, but when I found this great doc I told him I wanted to start with the most benign (side effects minimal) idea he had before moving on to Topomax or some of the others. I was already taking Nortryptoline as a preventative and have stayed on that. Lisinopril is just a blood pressure med, very cheap and only side effects are a dry cough and some dizziness, but it has worked wonders. I feel so blessed.

Even so, occasionally I get a bad week and start to panic - what if I need Maxalt for three days in a row? That is when I hear the doc's advice, and I relax.

This doctor and his partner run a regionally respected "Headache Clinic" here in Washington state. I have to believe he knows what he is talking about. I sure hope this info helps you!

Molly

hi pen, i have found in the past if i have a bad run of M where i have it for several weeks unrelenting the triptans just dont work, they dont work right from the beginning, the triptans take the edge off of it but it is still there, even with otc stuff it doesnt go, (obviously i dont know at the time that the M will last for weeks,) if i am havin one or two days a week with M and take a triptan they work, but if i am ill or stressed and fall into a cycle of M that is there every single day then the triptans dont work properly at all, this has happened to me twice last year and the second time i went on propranolol which i have mentioned b4 and that seemed to break the cycle, thank god! hope this answers your question without rambling.

I am like Chris. I do what works for me, not necessarily what is advised. Maybe if I was younger I would be more careful but being older I'm not concerned with what side effects "may" happen. I'm concerned with my quality of life NOW, and every day counts. Life is very short. I'm only satisfied with 100% pain free days. My migraines are going on probably close to 12 years. can't remember. I have had no ill effects from any drugs I have taken so far. And, when I am in pain, quite frankly, could care less. All I care about is no pain. I have been able to be almost pain free.

Thanks Theresa, you made it crystal clear, but it is odd isnt it....


Linda, I am older too, you know that
Before the Fibro rubbish I would be doing just what you are.
I HAVE to get rid of this stupid anxiety.

I hoped the CBT would work, but you know they chucked me off for missing appointments.

I wish I could be brave like you.

(MInd none of mine work as well as yours)

Neither my internist nor my neuro really seemed concerned with the frequency of triptan use. There are periods where I do take them daily.

The only instructions I've received are to not exceed 10 mg of Maxalt or 100mg of Imitrex daily and to never take them both on the same day. Although I did have one ER doc tell me it was okay to take up to 30mg of Maxalt per 24 hours (maybe okay for some, but I get chest pain with more then 10mg).

I've used triptans for several years....never really had a problem with tolerance or rebound issues when I do have to take them daily for several weeks. My only problem with them is there are some migraines that they will just not touch. Not sure why? They either work great or not at all.

Thanks for that. Very interesting, and yes they do seem to either work or not for most of us.

So hasn't anyone been threatened with rebound from Triptans?

More than 8 or 9 a month......

Doesnt look like it.

As a matter of fact, I have never been threatened with rebound for anything I take and it makes my doctors irritated that the insurance companies can dictate how much we should take. Never had rebound either.

What they tell us here is that you might not know you have rebound if you take medication most days.
If you take medication on more than 2/3 days a week. 15 days a month you probably hav rebound.
You wont know necessarily because you dont have a long enough gap to find out, just keep taking them door the headaches the drugs cause.

Mostly that is OTC, but, although originally they said not triptans, now they say yes and more than 8/9 and you are in the danger zone.

So Linda....you probably have rebound and don't know it......to their way of thinking.

Bring it on!!!!!