Migraine, Menopause and Meperidine (Demerol)

Hello,

I have suffered with migraine (no aura) for about 7 years now. The pain centers around my left eye (above it in the notch in the orbital bone, below it in my upper cheek and as the migraine progresses in the eye itself) and causes sensitivity to fragrance, light and sometimes sound. It becomes difficult for me to concentrate. Before the attack I get food cravings and feel as though my blood sugar is dropping, but eating does not relieve the feeling. Then with the attack I lose my appetite, get weak and shaky and sometimes get diarrhea. My left eye will feel dry. Very occasionally I'll get nausea. The weak and painful stage can last 1, 2 or 3 days. Afterwards I feel hungover.

I have identified lack of sleep, fragrance, bright light, flickering images and light, sulfites, heat and skipping meals as triggers.

I have tried at least 15 or so different prescription medications (including preventatives like Topomax and rescue meds such as triptans and ergotamines) in addition to over-the-counter medications, supplements, bio-feedback, massage therapy and new eye glasses. I have seen internists, gynecologists, an ENT, an ophthalmologist, neurologists specializing in migraine and an endocrinologist. I have even tried talk therapy (psychology). Two neurologists diagnosed my problem as migraine and another as a type of Trigeminal Autonomic Cephalgia (the class of headaches that include cluster headaches - though mine are not cluster headaches). My current neurologist doesn't think the exact diagnosis really matters as far as treatment goes, though he believes I most likely have migraine.

My attacks began in 2004 during peri-menopause once I stopped birth control pills. In 2005, at the age of 40, I became post-menopausal. The migraines subsided but the hot flashes became so bad I could not sleep - and not sleeping triggers my migraines. So I began hormone replacement therapy (HRT). The hot flashes stopped and I could sleep - but the migraines continued. Since hormones are associated with migraine I tried different kinds and doses of HRT, settling on the lowest dose of an HRT patch (Combi-Patch). The attacks would come and go in their frequency anywhere from 2 or 3 times a month to 2 or 3 times a week. Often I would have mild headache pain without other symptoms for many days. In about '07 or '08 the migraines retreated with attacks happening 1 or 2 times a month. I could live with that. However, in November 2009 they returned with great vigor. I was getting a couple of attacks a week. I saw more doctors and tried more meds and treatments. One medication or treatment after another failed me. Since about January of 2011 I have developed a chronic daily headache with full-body migraine attacks occurring 2 or 3 times a week.

The latest treatment plan is this: Venlafaxine (Effexor) as an alternative to HRT to control the hot flashes. It isn't as good as the HRT. The hot flashes have returned but are not as severe; I do not wake up in a pool of sweat. However, I do wake up some. So my sleep isn't as good as it was on HRT. But the daily headaches aren't as severe and the couple of migraine attacks generally aren't as severe.

This past Thursday I had a Monster attack though. The doc gave me injections of DHE, Torodol (Keterolac), and Decadron (Dexamethasone). The doc has now prescribed Meperidine (Demerol) as a rescue med. I'm to take it at the start of an attack and then once more 4 hours later if the migraine isn't gone. Does anyone else have any knowledge of or experience with meperidine as a rescue med?

You can imagine this is all very disappointing since most migraine information says that menopause should spell the end of migraines for most women. I have read of the other post-menopausal experiences here with interest. If anyone has any helpful suggestions I am open to them.

Thank you for this forum.

I understand what you are going though, and I hope it eases off for you. I have Meperidine at home and get a shot plus promethizine when I go to the Dr with a bad Migraine. I find it much more effective than the torodol and I do think that as a general rule it is used often for Migraine. I don't know what it is like to have the hot flashes, but I have been close and watched it twice, it can be a very dramatic condition. The only thing that I can offer is that a glass of soy milk taken at the same time each evening has seemed to make things more livable. Just make sure that your Dr knows as soy is sometimes contraindicated in some meds. Good luck to you and I hope that you get some relief.

=Bill