Grad school struggles! Has anyone tried taking melatonin?

Hey everyone, I've been in graduate school for 1 year and although things didn't go perfectly smoothly, I survived this far. That being said, I'm nervous about the coming semesters. I am in a occupational therapy doctoral program, 2 full years of class + 1 full year of clinical. I thought I had my headaches under control and was set up well for school, but over the first year my headaches steadily became worse. I just began the summer semester and I am starting to worry. The migraines are back to daily, and I easily take triptans 2-3x a week. I'm doing Botox every 3 mo. (year 2 of botox for me), and am taking a very low dose of amitriptyline (5mg) at night.

I can go into more detail about what I do to prevent the headaches (exercise, diet, etc), but I'm at a point where I'm doing everything I can think of and the headaches are still interfering in a big way. I really don't want to have to stop school, or drop classes to part time because then it will really delay graduation. My school is structured so we are a cohort and take every class together, If I miss a class I have a wait a year to take it again.

So...does anyone have any suggestions? It's a tough situation and I've been disabled by headaches before. I really don't want to get to that point again! I have accommodations from school and the OT dept. is working with me as I need, but really there is only so much they can do. If I can't sit in class, then I can't sit in class---and so much of what we learn is hands-on practice.

I can message my neuro, he will probably suggest increasing the dose of ami. There is one thing I haven't tried: melatonin. I was reading a study that it is found to be equally as effective as amitriptyline in prevention. Has anyone tried it?

Thanks in advance for your help! xo CG

I've tried Melatonin for sleep (no help), but hadn't heard of it being used as a migraine preventative. If you can tolerate it, the Amitriptyline dose has a lot of room to increase. And/or, maybe add another preventative.

For daily migraines it would typically be recommended to be more aggressive on the preventative front than only Botox and very low dose Amitriptyline.

What about trying other as needed meds to rotate in with the Triptans? There are misc meds like Diclofenac and Diomax.

I hear some folks do nerve blocks in between Botox.

Have you tried anything structured to help keep your stress down, such as a meditation class or biofeedback?

Massage? Insurance can cover massage with a prescription so you'd only have a copay for a certain number of visits a year. However, some insurance companies only do it for an injury, not chronic pain. My doctor writes it primarily for neck pain, which I also have (due to the headache).

Cefaly or Spring TMS?

Maybe get another headache specialist opinion to see if they would have different ideas? Ideally someone who could support IV meds to try to break your current daily migraine cycle.

As for school, can you take a lighter load each semester? I think that was the biggest help for me. I did summer classes each year to help graduate on time. Hang in there! Best wishes.

I have used melatonin for inducing sleep for which it is sometimes helpful. But be aware there are large inconsistencies in dosages between pills because supplements are not well regulated. So buy a good brand if possible. I don't know that it would help much with migraines ( unless yours are caused by not getting a good nights sleep).

Have you tried magnesium? That is recommended by the board of neurologists and it helps me.

By the way, grad school it tough for everybody. If you need to request accommodation for a chronic illness, don't feel hesitant to ask for it. You may need dispensation to take tests on different days or need more time on assignments or need to get notes from other students if you miss class for example.

Don't wait till you get behind or start bombing tests before you request help. I recommend you talk to your universities office for disabilities now, with a note from your doctor describing your illness. You can work with them on reasonable accommodations you may need in future. It is the law that accommodations must be made for those with disabilities, and occupational therapy programs should be sensitive to this (but may not be if you have not set up the situation in advance ).

You can be successful, but we all know that bad days or weeks can happen. You just need the ability to work around them. Good luck!

Hi,

First of all, it sounds like you are doing a great job juggling thinds, but sometimes Migraine can bring you to your knees.

I'm glad that you are able to get acomodations from the school. However, if you need more, definitely check with the disability of office.

You might want to check with your doctor about changing medications or upping the amitriplylene. Sometimes, you have to cycle through preventatives. I haven't had an experience with melatonin, but it might be worth a shot.

Hang in there.

Pain free days,
sailing

Hi Concord Grape,

I have taken melatonin when I was having problems sleeping. It is pretty powerful and you may need to be careful combining it with other drugs that make you drowsy or sleepy. You can try to increase your dose of amitripyline or swtich to a different preventative.

Jeff

Thank you everyone for such great feedback and suggestions!

Thankfully, the headache cycle I posted about got better and I have actually had a few whole days pain free! Phew! I'm not sure what broke it, but I have been trying to exercise daily and I think that is helping. Now if I feel a headache coming on and I go for a bike ride it actually will go away. I also think my stress levels were elevated because a new semester was beginning, so maybe I just needed time to adjust and find a routine.

Re: Melatonin. Good to know about the dosage and inconsistencies. I probably won't try it except as a last resort. I do get migraines from poor sleep, but I don't believe this was triggering the constant migraine.

Re: Massage. My roommates and I give each other massages about every other night. We found a way to massage that always improves my headaches, so I'm curious if it helps anyone else. (My pain is always behind my eyes, fyi.) Take both hands and add constant pressure in between the eyebrows. Then slowly pull outwards over the brows, temples, and into the hairline before releasing. Repeat.

Re: Cefaly. I haven't tried this or another TMS. It is something I am thinking about getting but has been put on the back burner. I had a neuro tell me that Cefaly wasn't shown to be effective in ppl like me (chronic). Does anyone have personal experience here?

Re: Magnesium. I have taken this daily in the past and haven't noticed much of an improvement with my headaches. I wish it did help though! Currently I have C0Q10, which I was taking but then stopped. I'm going to re-start it and see if it helps at all.

Re: switching preventatives. I've kind of been through the ringer on preventatives. Amitriptyline is one of the last ones I haven't tried that my neuro wanted to put me on. I'm not really sure what else we would try next.

I've never done nerve blocks--also a neuro told me I wasn't a good candidate for it. And i haven't heard of Diclofenac and Diomax but I will look them up. I do wish I had something else to take between triptans. I keep a steroid on hand if I end up in a really bad migraine cycle and can't break it, but at the time I wrote this post I had already taken the steroid and could not do it again.

As for the accommodations. I wish they were better but I don't really know what else to ask for. Right now I have the flexibility to take as many breaks as I need, miss class and turn in assignments/take tests later if needed. The problem is, if I do get behind the semester moves so quickly that I would never catch up!

Thanks again for all your kind words. xo CG