Maxalt Info from Neurologist

Hi all,

I haven't been on the boards lately, but used to post under username "Molly" or "Molly McClelland". Anyway, I met with a neurologist who specialized in migraines today, and among other things asked about how many times per week I could take Maxalt. He says that as far as he is concerned, there is no limit to times per week as long as you stay under the maximum allowed per day. I said that I had been concerned about rebound, and he said that he didn't think that was really an issue - and that too many of us are restricting our Maxalt use and making life more difficult. Of course, my insurance will only pay for 12 tablets per month, but that's another issue.

I was looking for a new preventative without the side effects of Topomax, which scares me for a few specific reasons, and he is starting me on an ACE inhibitor, Lisinopril, at 10 MG per day. I am also taking 50 MG of Pamelor, which he says I can stay on. Have tried beta blockers in the past but they make me so weak I can hardly get up the stairs.

Anyway, just wanted to put this info out there in hopes someone might see something helpful for them. Thanks for all the great support and input from this group.

Molly

Hi Molly,
Thanks for posting the Maxalt info. It is refreshing to hear of a neuro not bleating on about MOH. Although I have to be fair mine hasnt either. Its awful to think me might be depriving ourselves of some relief because of scare stories. After all I have yet to see any "proof" of rebound. It is all speculation.
What did you think of him? Did you trust what he was telling you?
If so, I hope the 12 a month is sufficient for you, and at least you don't have worry.
Welcome back,
pen

Thanks, Pen. I did like him. He was very direct, didn't resent or discount my research and awareness of the various options open to me, and seemed very supportive.

I do think 12 Maxalt a month should be enough - my pattern is 1-3 migraines a week, and I almost always respond to the first dose each time. What makes me crazy is the occasional week when I get 4-5 migraines, and have been afraid to treat them with Maxalt.

As far as the preventative, I doubt I will be lucky enough to have the first thing we try be the magic ticket, but like his approach of starting with those with the fewest side effects.

Molly

I hear you Molly. I get about 14 days when just keep getting them and I need to take more. (I am on Frova, but used to use Maxalt)
Those couple of weeks are awful. Am so scared to take them because of all the talk of rebound etc.
I mean who wants to be giving themselves a problem. But I give in when I just cant endure the pain.

BUT. I am inclined to agree with my husband, this is a bit of a cop out for the medics not knowing what to do.
Now I am NOT saying the problem doesnt exist, there are some very good people on here who have no doubt they have succumbed to this.

One of our top neuros says its less than 5% of us. My problem has always been, how do we know, and the only way apparently is to stop the med. Hmm, easier said than done,

I like your new guy, he sounds in the same vein as the last one I saw.
Its good you have confidence in him, makes a big difference. and I hope the preventative works. Like you say, be lucky, but you never know.
1am here in england, off to bed Good night.
Pen

I think it is really good to be aware of rebound headaches, but not pay too much attention to it either. If you sit there thinking every migraine or head pain you have is a rebound you are going to add stress to a situation that is already so stressful, therefore probably giving you more migraines/pain and then leading you to believe it is rebound when it isn't. Then you'll be suffering when you take yourself off your medication. Poo!

I take loads of meds for my migraines when I have to. When I don't have to, I don't take it anymore. There has been a week straight where I have taken narcotics daily. I am not proud of it, but it is either take the pills or live in agony. The only reason I think I can rule out rebounds for myself is before I took anything my migraines were the same.

Molly, I would trust your doctor but there is always that faint possibility of rebound out there. Just be aware. Don't go crazy about it, but if you notice your migraines getting more frequent see if that factors in there. Don't let this doctor shoot it down, either. Like Pen mentioned, great people on this forum have had their migraines reduce by following MOH rules.

Lovely to hear though, a doc not trying to scare us out of our wits! They are hard to find, I'd keep him!

Maxalt...I'm going to have to ask my doctor about that one when I go on the 3rd.

Maxalt works wonders for me. Almost always after just one dose, with only minor side effects. I feel a little spacey and dizzy, but the pain is gone and I can move on with my life. I feel so lucky that I can take it - I know many people posting here can't.

I can't, it doesn't work for me but it tastes great.

I was afraid of MOH for many years, finally I was so desperate for relief I said to heck with it and now I have .. relief.

I don't care how many triptans/painkillers I take per week/month/year as long as it works. However, in Canada insurance works differently so it may play a role, too.

I was looking for a new preventative without the side effects of Topomax, which scares me for a few specific reasons,

I was afraid of T too, also for many years, and now I wish I tried it sooner.
For me the side effects subsided with time and the relief is worth suffering some minor one that stayed.
I have tendency to sinus infections and runny nose so I have something up in my nose (lol) constantly.
But I'd rather have that than severe Ms.

Risa

Thanks so much for posting re. the Lisinopril and the Pamelor - I need something new to ask about when I see my dr....

And Please keep us posted on how it goes for you with these drugs..

I only get 12 Maxalt a month from Medicaid.... If I could take one a day, I would live a fairly normal life..wouldn't that be wonderful?

God Bless,
Holly

I'm like Risa on this one. I take as much as I need of anything I have until the migraine is gone. It seems the more migraines I avoid or abort as quick as possible, the less that I get. No rebounds for me - ever.

lovegia wrote:I can't, it doesn't work for me but it tastes great.

I got off the melt and took the pill. Hated the taste.
I am never sick with my migraines, but Maxalt melt did it.....
Arent we a diverse bunch (With "something" in common)

Did your dr. say if this was true for all triptans, or just Maxalt?

I tried Maxalt early on in my treatment (when I was first diagnosed in '97) and it didn't seem to work for me, especially the melt. I've tried the tablets once or twice since then and it has not really worked on anything stronger than a 3 or 4 level migraine. The side effects were very mild though. The dosage might not have been high enough, however; the dosage I took was a low dose.

Does Maxalt come in generic or is it still just brand? I think it's been around at least as long as Imitrex. That't the big advantage for me in taking Imitrex, that it comes in generic, so it's cheaper. I am used to the side effects and they don't bother me any more; plus, the side effects are not as strong for me with generic. I don't know if that's typical or not.

If Maxalt came in generic though, I would try it.

estre004 wrote:I'm like Risa on this one. I take as much as I need of anything I have until the migraine is gone. It seems the more migraines I avoid or abort as quick as possible, the less that I get. No rebounds for me - ever.

I think I am now to the point where I wold do the same Linda.
Sadly the Triptan is helpful but less than it used to be.
The OTC and NSAIDS they gave me don't touch it.
I haven't been offered anything else except MORE preventatives.

I would love to have something that actually works. I am not sure I would care about rebound. If it worked I'd take it.

Auntie Bubbs if you mean is the rebound risk true of all or just Maxalt, I would say all Triptans.
They do vary, and if you got some relief, its worth trying a different one, there's about 8 of them or so.
They are all slightly different, but the rebound risk or no risk would be the same.

My neuro was far more concerned about the OTC.
He put my Migard up to 12 from 6 and told me to take them and leave out the Excedrin.
If I needed a pain killer take soluble aspirin in high dose.

One day we will get some consistent info (not!!)

I rarely take OTC anymore--only as a preventative on occasion. They are worthless for migraine.

I agree LInda, they are. I use them for the other pain, and sometimes they work pretty well. Other times they dont do a damn thing. I never take a second dose if the first ones dont work.
I laugh at the name "Excedrin Migraine"....if only.

lol strange pen, I thought it tasted like tic tacs sort of. Pepperminty mmgoodness. If it worked I'd be happy! I'd be thinking candy instead of medication!

As far as Excedrin Migraine and all the other OTC migraine products, I have some words for the manufacturers. I hate them for just existing. All my relatives turn to me and say, "Well why don't you just try Excedrin migraine?" When I'm in that much pain I wan't to smack 'em. If it was that simple, dontcha think I'd have thought of it already? Thats like saying take some vitamin C and your cancer will go away.

You are so right. The other thing I hate is "I cant understand why they cant do anything for you" "I saw (whatever) tablet in the pharmacist, you should try it......grrr

I so agree on the Excedrin Migraine ads. Just having them on the air perpetuates the myth that migraines are "just headaches". If folks only knew the realities we face in plotting out our triptan allowances and balancing taking enough but not risking rebound, etc. Sure, I'll just take two EM and be ready to party in an hour.l......not!

What really bugs me is that Excedrin Extra Strength, and Excedrin Migraine Excedrin Menstrual Complete are exactly the same. What are they playing at? I wonder if the price is the same.

All three contain:
Acetaminophen 250 mg
Aspirin 250 mg
Caffeine 65 mg

They're trying to act like the products are different. The only thing different about them is the label.

http://www.excedrin.com/extra-strength-excedrin-drug-facts.shtml
http://www.excedrin.com/excedrin-migraine-drug-facts.shtml
http://www.excedrin.com/excedrin-menstrual-complete-drug-facts.shtml

Chris

Same in England Chris. We dont have Excedrin here we have Anadin Extra.
Slightly different:
300 mg aspirin,
200 mg paracetamol (acetaminophen)
45mg of caffeine.

They are labelled "migraine" which is a bit better than Excedrin, but you can get some others which have ibuprofen with migraine added.

It does give the public the idea we have a little headache and make a lot of fuss.
Same with the hangovers, people over indulge food and drink and call it migraine, and so many people have decided they have IBS....it makes me so angry.

Maybe this is partly why we dont get taken seriously enough.

The inactive ingredients in Excedrin Migraine is different, which may not mean much to anyone else but us. We are sensitive to all fillers and whatnot so that might very well be the selling point right there. Stupid.

Stupid especially since they don't even work. It's just as good as taking some ibuprofen, naproxen and drinking a cup of coffee. Especially since that works better for me anyhow. Can't you tell how much I hate Excedrin products?

I secretly doubt all the people who say they have migraines when they tell me their treatment method is Excedrin Migraine. I never say anything because who am I to judge, I am no doctor and they might be a fellow sufferer. After all, if it works for them it's probably my jealousy kicking in that makes me think, "Yeah right you have migraines..try you have a bad headache, get it straight."

The inactive ingredients are different? So maybe the pills are a different color? If anything I see that as a negative. They are trying to fool people into buying more products and I resent the hell out that.

Chris

Think about that Chris. The fillers are different. I don't know why they are but MAYBE they are different to be a little more sensitive to migraneurs triggers. Maybe it is because the colors are different, but I highly doubt it since menstrual and extra strength are the same. I also doubt it because carnuba wax has nothing to do with color.

Fillers were the possible cause of a huge spike in migraines for me when I was switched from one brand of generic to another in my preventative.

I still hate Excedrin, but it would be nice of them to think of something like a sensitivity to certain ingredients that might bother us. I don't see it being negative at all.

As it seems to me on the CVS website the prices for extra strength and migraine are the same. The menstrual complete is different but they are gelcaps, and also a different quantity.