Take the medication early, but what about rebound/MOH?

But dont get rebound/MOH.
How do you all discern this please.

If I took medication as soon as I felt pain, I would be overdosing OTC and running out of Triptans by mid month.
Also we are cautioned not to take anything more than 3 days a week because of MOH.

This for me is contradictory....

So what does everyone else think/do please?

I take meds when I have to. Thats it. I don't take triptans because they don't work so I take my pain pills once it gets bad enough where I can no longer function. I would be getting rebounds if what they say is true for everyone. I have only had rebounds from Nucynta, and it was more of a side effect as I had gotten the headache immediately after taking the first pill.

I take fioricet with codeine about 3-4x a week, a bit less lately but on bad weeks I take more. Last week I only took it one day I try and alternate out with vicodin 10/325's but I only use the vicodins when my migraines are unbearable and I know fioricet wont work. I don't get that many of those as my family member has the script and shares them occasionally and only when I am concidering the ER.

Hope this helps.

I learned the sooner I take triptan the more gentle it is on me. I get daily headache or M even when not taking anything.

I have gone clean for months to disprove rebound.... they happen with or without meds. I regret all the times I waited.

My neuro knows of my usage, and knows i buy in canada.

Thank you. I think maybe the rebound/MOH stories are meaning I am suffering more.
I dont have a medication that actually works that well, but sall help is welcome....isnt it....

So you are not scared of rebound? I have had it rammed down my throat....

How do you know if you rebounded? I might but cant tell.

Thanks for this.

I don't know if the rebound theory is more baffling or the "trigger" theory. Neither seems to be the problem with me. If it wasn't for the people on this forum that believe in the rebound and triggers, I would say it was all crap. But obviously it is an issue for a lot of people.

Pen, I can tell if its a rebound headache because I never get headaches. I strictly get migraines, and if I do have a headache I can count it to either a hangover from drinking, eyestrain, or MOH. That's how I knew about the Nucynta headache. I actually had a migraine and a headache at the same time. I strongly believe the Nucynta headache was a side effect and not MOH since like I mentioned, it happened the first time I took it..not after taking it for a few days.

MOH I think are a load of bull too but just like estre said, if people on here have problems with it, I can't down that. I just don't get them. Everyone is different. I think it is not as common as doctors seem to think it is though, and I think MOH is less damaging then being in pain non stop from a M. Hope I helped.

Thanks Lovegia for stating that MOH (if it exists)is probably less damaging than a migraine. I have thought all along that when people are concerned about this drug or that drug or afraid of being addicted etc. that none of them could be as bad as having a migraine.

lovegia wrote:Pen, I can tell if its a rebound headache because I never get headaches. I strictly get migraines, and if I do have a headache I can count it to either a hangover from drinking, eyestrain, or MOH. That's how I knew about the Nucynta headache. I actually had a migraine and a headache at the same time. I strongly believe the Nucynta headache was a side effect and not MOH since like I mentioned, it happened the first time I took it..not after taking it for a few days.

MOH I think are a load of bull too but just like estre said, if people on here have problems with it, I can't down that. I just don't get them. Everyone is different. I think it is not as common as doctors seem to think it is though, and I think MOH is less damaging then being in pain non stop from a M. Hope I helped.

Oh thank you. I am feeling heartened. Because I have a lot of pain, and some daily. I have been told it is probably rebound or MOH. I am struggling with the definition now. In england they just seem to have changed the name to MOH. I do have more pain than I used to, but 8 years ago I was taking twice as many OTC as I am now, yet having cut down I have this pain. I am taking more triptans. 8/10. 3 years ago it was 6/8. I am not at all happy about this, but I have no idea why I got worse,nor if the medication has any part to play in this at all. I agonise over each and every tablet in case I am causing the very pain I am wanting rid of. There is no way to tel lit seems. But I have not increased the dosage of the OTC, I almost never take more than 2 in a . I dont take them every day, and can go 3/4/5/6 days without. Triptans, I seem to have a weird cycle of migraine.
I get a bad run whcih csan be 14 days where I take them up to 4 times in a week, but then I get 4/5/8 days where I dont take any. As you can tell I am confused, and concerned.
There are people on here who really feel they have this problem, we must respect that, we are all so very different, but we are told it is less than 5% of us. Am I one of that 5%??
If only they could come up with clearer guidelines.

It is good to read your description of how you actually knew. I have never had anything like that.
Thank you

Your welcome guys

Pen, you should stop agonizing over it. I'm thinking that you are so concerned over how many triptans and meds you are taking that it is causing you stress related pain. I think you need just let go, understand that you need the medication. Your in pain! You take your meds because you need them. I bet if you stopped taking all the meds you'd still be in pain and you'd still need to take something anyhow. Let go if you can and see if the stress is the cause. It may very well be.

Being that you are all over the place with your triptans I doubt they are causing MOH. If you take 4 in one week, then the next week you take none I don't see how that could cause rebound. I don't even see a rebound pattern there. Relax sweety. Take it easy and stop beating yourself up for taking the medications you need to feel better.

Also, I'm under the impression that MOH are headaches. Not migraines. If the pain you are feeling is migrainous in nature then chances are its not MOH. My headaches feel like light pressure around my entire forehead, tired eyes, and pain behind my ears and in my neck area. It is almost like a rubber band is strapped around my forehead. I hope this helps as well.

Excuse this brief reply. I have been on her so long I have given myself a headache...very rare for me.
Thank you for the sweet words. Sorry not even sure of your name.
I will be back but thank you my dear, much appreciated.
pen

I have been successfully taking Maxalt for 12 years now and I have never had a rebound headache. Very occasionally I have taken more than 4 pills in a week. A neuro, 2 surgeons, several GPs all told me that taking pain meds early, when the pain hasn't yet fully ramped up, is the best way to go. And this applies to other pain as well as migraine pain. That advise has proved to be true for me.

Chris

Excuse brevity Chris, bad this morning. Thank you for your info. How do you know you are not rebounding please?
Thats what I find so hard to fathom. I am just taking my 4th one this week. I dont want to, but I know I cant get through, nor wait any longer.
Thanks.

I hate to do this to you Pen but while you are suffering head pain can you do me a favor and write down what it feels like. All different types you get, I know it may take a bit, maybe a few weeks but it might help us/me tell you more about your migraines and headaches. Also, please include information of the triptan or medication you used to abort the pain. If you don't feel comfortable sharing that info I completely understand, but I think if you at least described your migraines/head pain very well some people on the forum would be able to relate a lot better and offer more advice about MOH and what they feel like.

Here's an example of what my head feels like at the moment:

My upper right corner of right eye feels very sharp. pain goes all the way back deep into head. The rest of right eye is very sensitive and all around it feels like a shot glass is being shoved into it. Heavy pressure. Right temple is aching and pounding, as is behind my ear but not as bad as the temple. My right brow and about an inch upward is very painful to the touch. My whole head is sensitive and I can't brush or wash my hair right now. Right eye is tearing and drooping.

Hope this helps. Even a description of not every headache but just the ones you suspect to be MOH would be good. I haven't heard you describe your head pain but in a previous post you had stated yours aren't migraines. I'm unsure what your head pain feels like and I'm rather curious to know.
Thanks for the patience. Sorry if I don't make sense, I'm having a horrible head day.

Thank you (still dont now your name). What a kind offer, I cannot think why I have never done this before.
Probably because it sounds a bit self pitiful, and its so subjective, but yes....here goes.

Today Saturday.
I woke over and over in the night and each time I had global aching and pain in my right neck.
By 10 am when I woke properly (yes I slept late, but only dozing, didnt want to be awake in pain), it was like someone was ripping off the back of my neck and head. And I was pulling on my hair to stop it.
By 11, I couldn't take it so I took some OTC (excedrin alike)
11.45 it moved into my right side of head. Mainly temple and top. Sharp like stilleto stuck in there, need to hold it in.
2pm couldnt stand it any more. Took a Migard (so dint want to, only had one on Wednesday!!!)
In an hour, side effects....woosy, slightly nauseous. No relief
2 hours tiny improvement in both.
Now 6pm. My neck hurts a lot. Tender to touch. Ears ringing. Pain on top of head (rt) It doesnt go real deep it is near enough to the surface I feel I could jank it out. It is like a sharp bit of metal I think. It is also behind my ear. and I feel pressure in my teeth on that side, especially the top. Like something has a hold of them.

Thats it so far today.
It almost never throbs, it is like toothache in my head, nerve thing. It can be either side, but predominates on right.
Almost always there when I wake.
No eye tearing as you describe. Thing most likely to make it worse is going in car. I think this is my neck.
Lying down does not help. Lot of the time keeping still doesnt either.

I wonder if this tells anything? And I thank you for your kind suggestion and effort to make sense of it for me.
Think I am getting too old for this. Oh should add I have been told I have more than one kind of pain. It hasnt come from me.
Myofascial pain due to FMS and Migraine. BUT I am open to conjecture.
BTW who is that gorgeous baby in your picture.

Thank you
P

She is my daughter I usually don't disclose my name on public forums. Not because of you guys, but just because I have some nosey family that like to google my name. I will PM it to you though, so you have a sense of who you are speaking to.

To me, the stabbing sounds very similar to the pain that I feel. That stilletto feeling you describe is very much the same as mine. My neuro tells me that pain is indeed a migraine. The unilateral pain is usually a sign of migraine as well. I don't believe it needs to throb in order to be a migraine, otherwise I would be so off on my diagnosis!

When I take medication, even though it isn't triptan, I feel as if my pain comes up to the surface too. It doesn't remain deep like the stilletto, but it comes up towards my eye/skin like the sharp metal you describe. This is only after I take medication and the medication isn't strong enough to take the pain away completely.

Lying down never helps me, it usually makes it worse. I have to be elevated. The car rides kill me, but I believe it to be the motion not neck pain or placement. I cannot be in a car at night without closing my eyes, the lights trigger a migraine. I still feel uncomfortable with my eyes closed because I feel the motion.

Occasionally I also get pressure in my mouth as well. I find it to be more in my gum area, but it does feel like someone is trying to pull my teeth out. That does not happen often, but I recall feeling that way and wondering if I needed to see a dentist. By the time the migraine went away I never had a problem again.

Hope this helps! Feel better Pen, and stop beating yourself up about the meds, okay?

Wow, Oh nameless one.....snap!!!
Thank you for this. It is kind of you, especially considering your own head, and the little cutie you have to care for.
The only small difference is one of opinion, not symptoms.
The 3 neuros I have seen all think mine are not all migraine, whereas yours does.
But who are we to know?? I am rapidly coming to the conclusion that after 20 odd years of this, I am non the wiser.

So any clue on MOH??? Sounds like you think I am worrying un necessarily....

If only the medication actually took the pain away I think I would just take it and be damned.

Thanks again.

All I can tell you about MOH is that I had the exact same symptoms before I even saw a neurologist. Same frequency, same everything and I had never taken a thing for it. They have not gotten worse since taking medications. They have gotten better since taking topamax. I do not believe this is MOH at all, otherwise why would I have had the same problem when I had not taken anything for it at all. My system was sparkling clean.

To be honest though, even if it was MOH I honestly believe that with the frequency of my migraines being as bad as they are, I'd take the meds anyways. Not much of a difference between 4-5x a week in pain without meds as there would be with meds. I just don't want to be in pain, and I know stress aggrivates my pain so I don't worry about it.

If I only had migraines once a week and medication caused them to spike up to 4x a week, sure i'd do some experimenting and try to take myself off of all triptans/otc's for a while. That doesn't seem to be the case for you or I though, so I see no need to stress over it. Your head pain is going to be there and probably be frequent regardless of the amount of medication you take IMO.

Have you concidered narcotics as a treatment for your migraines in addition to triptans? I do not know if that is possible due to your other conditions..maybe because of other interactions. It would probably be handy to take a triptan and then follow with a narcotic if the triptan failed. At least you might get relief.

pen wrote:Excuse brevity Chris, bad this morning. Thank you for your info. How do you know you are not rebounding please?
Thats what I find so hard to fathom. I am just taking my 4th one this week. I dont want to, but I know I cant get through, nor wait any longer.
Thanks.

Well, I can't guarantee a 100% accurate answer. I wish that I could. Everything I have read about rebounds, both here and elsewhere, tells me that I don't get rebounds. For one thing, rebounds are headaches, not migraines. I don't get headaches unless I physically hit my head on an object. How is the pain different from a migraine? I am talking about how it feels to me. Others may have different experiences.

When I have a migraine, the head pain is located on one side of my head. It is throbbing, pounding. The pain feels like it originates deep within my skull. I also have nausea, light and sound sensitivity. OTC meds such as aspirin, acetaminophen, and Ibuprofen don't touch the pain at all.

When I bump my head on something, it doesn't feel much different than when I whack another part of my body. The area is sore and tender. The pain feels like it originates on the surface of my skin or slightly below the surface. It feels like a bruise. OTC meds such as aspirin, acetaminophen, and Ibuprofen will eliminate the pain.

So if rebounds are headaches, I do not get them. I'll throw this in too. When I get a migraine, I take a Maxalt early on, when the pain starts. The Maxalt doesn't just reduce the pain, nausea, etc. It totally wipes it out. And the migraine does not come back when the Maxalt half-life is over. So if rebounds are migraines, I don't get them either.

I hope this explanation is what you were looking for. But even if what I am saying is clear, your experience may be entirely different.

Chris

Pen, to me it sounds like what started off as a headache turned into a classic one-sided migraine. Perhaps they are migraines when they start off, I don’t know, but I also often wake with them and then they’re usually all across my forehead. In a couple of hours they will have migrated to one side and feel, like you said, a toothache in your head. For years it was usually the left side but in the last year it has changed to the right. Sometimes it goes to my eyes. These are the most difficult to deal with, it takes hours for them to go with a Migard (frova). If they come on during the day though, the pain usually starts in the temple straight away and they’re dealt with much more easily.

I too wasn’t sure about rebounds/MOH but after the enforced ‘medication break’ recently, I have to assume I had them. I was taking 5 or 6 Migard a week and when I stopped taking them I had the worst migraines I had ever had. To say they were agony would be an understatement and that was for hours and hours on end. I’ve had 3 day mega hormonal ones before but these were even worse. I never want to go through it again. If I ever get myself into that situation again, I would ask to be admitted to hospital for intervention. It’s early days but I think things are a bit better for now (very frightened to say it of course). I’m still getting them, I know they won’t stop but I’ve just had another 3 consecutive days without medication – can’t believe it. I can’t think this is all psychological.

Pen it does worry me that you are thinking continuously about your migraines/headaches and may be exacerbating the situation. I totally understand your desperation, I’ve been searching for the elusive reason/cure for years. I do know though that when I’m thinking, writing, concentrating on migraines, even if I think I’m fairly relaxed, my jaw is tight, teeth probably clenched etc, I mean how CAN you be relaxed when thinking about the b****y things. Just a thought that you may be piling on the stress by constant agonizing?

Take care
Liz

Thanks Liz,
I do appreciate your coments and your concern.
My one saving grace is my sense of humour.
As soon as I get the tiniest break I dont even think about migraine.
Soon as the pain backs off, I run between the clouds.

I am not a teeth clencher at all. I might be a shoulder tenser though.
I have a healer friend who has taugth me techiques so that I at least shed some of the tension.
She tells me I am good at physical relaxaton, but crap at turning off mentally.
So. soon as I can I go for a walk or whatever so that I get out of my silly head.
I do find that if I can get to a place where I can distract myself. Even if the grandkids come (noisy), I can get away from the pain. Doesnt always work, depends on how bad it is.

Until the migraines got so bad and took away my life, I was kind of in denial and just accepted them.
However the last 2 years, I haven't been able to do that because I am now in constant pain and cant function.
I also had a bad stomach bug which flared up my IBS last Easter and the Fibro seems to be in flare.
Between them my life quality is very low right now. Spend most of it on the couch. Not good.

I have never taken as many Triptans as you, I hope I dont have to. How awful for you.
Actually I cant, they wont let me have them.
I did once take 13....
I have had better times, but not since last September. MAA told me its the weather!!! They insist it is, they have been flooded with desperate people.
Last March and June were much better months, but I wish I knew why. Had 8 and 10 day gaps. Wish I could do that now.
I pray this Spring brings some relief.

I have some Almotriptan to try. Migraine action suggested I get some. 2 reasons:
One the waking migraines need hitting with something tougher than Migard.
Two MOH is less likely if you alternate the meds even if they are Triptans.....This is what I have been told and the GP concured. I havent found the right moment to try them yet.
I need to have a mig. come on a bit later in the day to first try, as I am a bit scared in case it doesnt work, or the side effects are really bad.
I never used to be like this. The last few years I have changed so much. Not sure why. Bit worn out I think.

Anyway, thanks ever so for thinking of me. I hope yo continue to get your med. gaps. Its wonderful isnt it.
Pen