Triptans don't work for me

Hi folks~

I haven't posted in a while but wanted to ask if anyone else finds that triptans do not work well for them. I have tried three so far: Imitrex, Amerge and Maxalt and they've helped maybe 20% of the time, even when I take them at the first sign of the migraine.

Obviously, they aren't going to work well for the migraines that I wake up with that are already in progress but my migraine Dr. insisted that they would help. Nope, they haven't. So then I am left to take 800mg of advil, or another rescue (percocet or codeine) which I am wary of due to the risk of MOH.

I feel like maybe I am just one of those people for whom triptans just don't work. I keep trying though, because my Dr insists they are the drug of choice and she frowns upon the rescues (MOH and all...) Actually, at this point, once the migraine gets bad enough, nothing works too well except NSAIDS.

I am frustrated because I need to know I have something that will work when I get hit. As you all know, when we need to function, we need to function or at least be put out of our misery. I know sometimes I am in so much pain, I cannot stand it.

Anyway, I'd love to hear from anyone who has had a similar experience. I am seeing my Dr in early April and I reluctant to hear "try another triptan" as the solution, as I am wary (and weary) that another triptan will even work for me.

Thanks for listening.
Jane

BTW, I am on 90 mg Topamax daily which does help somewhat - I'm sure things would be worse without it, but I still have on average 1-2 Ms a week to deal with (sometimes more, sometimes less, depending on my cycle.)

There are others who post here that do not get relief from triptans. I had to take 100 mg Imitrex. 50 mg was not effective.

Have you tried injection or nasal spray ? If 800mg nsaid gives you some relief have you tried a small amount of caffiene

with that ?? Hope you have relief soon.

I hear you Jane. There is so little that can be done, it seems.

Imitrex used to work great, sometimes works, and barely works. I take it anyways because its better than nothing.

There is a way to see if it has value, and I do this every once in a while, but never when I have a real bad migraine. That is take a sumatriptan with no painkillers for 4 hours and see what happens. Sumatriptan will likely get worse before it gets better, but it should make things better within that 4 hours. That is the test. If you are on painkillers, you can't guage what it is really doing. If you have a killer migraine, then it may be too late for the abortive, or it is just too painful to do the test But in the 2-4 hours, something should happen.

I"m on 200mg on Topamax. Maybe you should talk about upping the dosage. I went from 19 migraines a month to 14 a month. The first two years I was on 100 mg of Topamax.

Just my two cents

Thanks for the replies.

Enigma - I always take the triptan first and give it at least 2-4 hours to work. I never reach for the painkiller until I am sure that the triptan is not working (which is usually always!) and it is bad enough that I could end up in excrutiating pain and/or end up in the ER.

There have even been some occasions when the triptans seem to make the migraine worse believe it or not. I really think I am just one of those people who cannot take triptans.

I am ready to go up to 100mg of Topamax at this point - I am a very slow titrater - so, maybe that will help a bit too.

Again, I really appreciate getting input from others. It helps alot.

Peace,
Jane

I tried Amerge and it didn't do anything for me. I'm currently trying Frova with the same lack of results. Very disappointing.

I'd definitely try more of them, as they are all different, especially if you can get free samples. Its not unheard of to try quite a few and not have them work, and then one works. Or, try a combo of an analgesic + Triptan + rest + time (+ nausea med if needed). That said, yes, its very possible they may not work for you. If your doctor runs out of ideas you should try another one who may have more. You can get rebound with Triptans too, but yes, I would also be a bit wary of rebound. Pure narcotics might be a better bet for avoiding it than the otc or combo analgesics, but of course, tough to get (although once I failed many Triptans I was able to get them and have done well on them). Best wishes.

Have you ever given the old ergot based drugs a try?

I think this has been discussed previously here but you can read this (skip to the second half of pg. 2):

http://gvhiemenz.appspot.com/www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/12/20/DDT41GQN7J.DTL&ao=2

I know the CGRP antagonists aren't out of clinical trials yet, but it sounds like it will be something that you can try out in the not too far off future.

Jane,
My daughter has tried all the triptans and none help her. I get relief from Amerge, Frova and Relpax, but no others. I think it is worth trying all of them , just in case. My daughter uses Fioricet, but usually has to add an NSAID. She is trying Nortriptyline as a preventative right now. She has tried several other preventatives without any help.

I take Inderal as a preventative. I would not worry about MOH so much, if that is all that helps you. I have to take daily small doses of narcotics from all over pain due to chronic Lyme disease. I have been doing that for 4 years and have no more migraines than before. I know everyone is different, but it works for me. Larger doses still help a bad migraine (I am talking 1 tablet as opposed to 1/2 and an extra strength Tylenol). I hope you find something to help.
Hugs,
Cindy

According to the Medical Trials, Migranal Nasal Spray was shown to produce a reduction in nausea and sensitivity to both light and sound at 2 and 4 hours compared with placebo. Over 50% of patients did not need any additional migraine diagnosis during the 24-hour period following a single 2 mg Migranal treatment. Consult with your doctor n get information in reducing the pain.

Hi,

I have tried them all and the only ones that ever helped were injectable imitrex and amerge.

Injectable imitrex worked for about a month- though I was taking it five times a week and my neuro told me that i couldn't do that because it could damage my heart. Also, I got rebound from the imitrex. Eventually it did not work at all.

Amerge worked some during the first period of remission- lasted eight months, but did nothing when the headaches came back full force.

I have chronic intractable migraine/NDPH, and that may make a difference as there is no clear start to the migraine.

My doctors have decided that rebound/MOH is not a factor in my case anymore. My neuro actually said "You are way, way past rebound."

I would ask about the older ergot drugs- Migranol or DHE as well as midrin. I believe you also said that NSAIDS worked best- have you ever asked about toradol- I beleieve it comes in pill form. I know some people here have been given toradol shots to use at home. This might be an option.

I hope you feel better soon.

Pain free days,
sailingm

Thanks for the replies.
I actually do have Midrin and it helps some of the time. I also gotten Toradol in urgent care a couple of times and it worked quite well. My Dr will not give me at home injections of Toradol, even though she knows it works for me :-(.
I do have to be careful though with any NSAIDS due to stomach issues, so I'm not sure about a pill.

I am really wary of the older ergot drugs because of side effects too. Sometimes I feel that I have nowhere to turn.

I have chronic migraine, that was daily before Topamax, though I still have some bad stretches. I don't think I have MOH though, because I am so cautious about sticking to 2-3 times a week of any abortive/rescue med - to the point of agony over it.

I am feeling lousy today. Have had a headache the past 3 days and am trying to get through it without taking anything - ugh.

Thanks for the ideas everyone.

I know what you mean when you say it feels like you have tired everything. It seems that meds just stop working after a while. I take amerg right now, but it only helps some not completely.

I have used Migranol (nasal spray), DHE (suppositories), Toradol (Pill form) as well as all the triptans. I hate Toradol, It makes my skin crawl but when I end up in the ER with a migraine its always what they insist on giving. DHE are hard to come by as they aren't commercially made anymore, if ever.

If I was in as much pain as it sounds like you are, I would try anything! Actually I have tried everything. My next step is Botox.

I haven't had any success with Triptans. A few of my friends who have vrey occasional migraines swear by them and consider them a wonder drug, sooo... I had a lot of trouble with the side effects from Imitrex and Amerge. I think at some point or another I have tried all of them and they just really didn't help the head pain, and then my heart was crazy and other stuff, so I just stay away from them now.

Steph, if you don't take triptans what do you take? My nero won't let me take narcotics or any pain killers like Aleve because of rebound headaches. I guess you could take Ergots....

Botox, 5mg oxycodone as needed ( I usually cut that pill in half) and occasionally ibuprofen.
That is it! Since starting the Botox my usage of anything has decreased. In fact, I had Botox Monday, and my Neuro was telling me how happy she was because I was one of, if not the worst patient she has ever had! Now, I have headaches every day even with the Botox, BUT they are so low on the 1-10 scale that I can deal with them. I still watch what I do, but compared to before, THIS is so much better. I probably won't be pain free, unless there is some miracle in the future, but honestly, I am not sure I can go back. I had a really bad few weeks here, waiting to get the Botox back in, and thought, "I used to do this everyday, all day, this bad??? how???" I don't know how, but I did. I didn't do real much of anything, but even with the pain I am in, I will take it if I dont' have to go back!

I really want to try Botox. My doctor is still training on how to do it apparently. Or maybe he is doing the worst cases first. Though my migraines are daily they are low on the scale most days. Once or twice a week I get a bad one. I just want my life back. Six months ago I was having 6 to 8 migraines a month. I am a newly wed and my husband is very supportive, but I don't think he really gets it.

Well I can relate to that! I had my irst migraine, that lasted 3 weeks, 24 hours after returning from my honeymoon! The first 2 years were fine, as far as the hubby being supportive, then for a while he got a little tired of it, then he was just kind of numb to it, AND THEN HE GOT A MIGRAINE! He has only ever had one, but that totally changed his whole idea, and now he is back to being really supportive. I am sure this is not how you planned on spending your marriage, who would? But, you will get through it and it will work out. We have been married almost 9 years now and although the migraines are still there, the 'issue' of them in our marriage isn't. Sometimes they just don't know what to do, can't stand seeing you in pain and not being able to help and it eats at them. That is what my husband has said about his feelings towards the migraines.

That brings up a good question, do any of you know of support forums for the families of migraine suffers? I would like to find such a forum for my husband so he can get a better idea about this awful disease and how to cope with it from a spouses standpoint. I know it is as frustrating for him when I have a headache as it is for me.

hmmm... I dont really know of a amily support forum, but let me think on it a bit, there is one I know of that I don't use that seems like there are a lot of family members that are concerned for their migraine person... I will get back to you!

maybe look here: http://forums.healthcentral.com/discussion/migraine/forums

I THINK there might be help for non-sufferers, but could be mistaken, I am going to look at it myself.

A few things: First I think you owe it to yourself (general you) to try every single triptan. Many people find a couple that work well for them and find that others are the same as sugar pills. Second, as far as personal experiences with ergots, I have been on Migranal and intramuscular DHE injections. They really didn't do anything to reduce or eliminate an attack for me. Other people have had much better experiences, and you can only know how you'll be affected if you try a particular med. Finally, it is very helpful to many of us to seek out the triptans with faster delivery methods that avoid the stomach, such as Imitrex injections or triptans that come in nasal spray form.

I've written some about the problems with digestion associated with migraine disease that you can read about here: http://somebodyhealme.dianalee.net/2011/01/why-are-pills-hard-for-migraineurs-to.html

Migrainegirl wrote:That brings up a good question, do any of you know of support forums for the families of migraine suffers? I would like to find such a forum for my husband so he can get a better idea about this awful disease and how to cope with it from a spouses standpoint. I know it is as frustrating for him when I have a headache as it is for me.

This is one such forum I've heard about, but it doesn't seem especially active right now:
http://forums.delphiforums.com/n/main.asp?webtag=haspousesuppor1&nav=start&prettyurl=%2Fhaspousesuppor1

Migrainegirl, http://www.mdjunction.com/migraine-headaches is the other forum I am on. It includes families however it isn't specific to them.

interesting information!!! thank you!!!

teppy000 wrote:Migrainegirl, http://www.mdjunction.com/migraine-headaches is the other forum I am on. It includes families however it isn't specific to them.

Awesome! I didn't realize family members participated there. I should add that link to my blog.