Daily Triptans for daily migraine

Friends,
I would never suggest a treatment for anyone - despite my education and experience I am in no position to suggest to anyone what is appropriate for them. Too often I have had physicians treat me with cookie-cutter medicine- in other words, not treating me as an individual but instead treating my "complaint" (I hate that word) with treatments that may be appropriate for the average migraine sufferer (though I'm not convinced there is such a thing.) Nevertheless there may be people here interested in this research from Dr. Robbin's website. He does inspire trust in me.

http://www.headachedrugs.com/archives/daily_triptan_use.html

http://www.headachedrugs.com/archives/long_term_triptan_abstract.html

http://www.headachedrugs.com/archives/nothing_works.html

http://www.headachedrugs.com/archives/triptan_safety.html

http://www.headachedrugs.com/archives/naratriptan_study.html

I found the last article, even though short, of great interest. It describes how daily naratriptan (Amerge) helped some people with daily migraine revert to an episodic pattern. I was on this path when the rug was pulled out from under me- I was using less and less medication including naratriptan. Now I'm back to where I was and possibly worse due to changes in prescription reimbursment. (I hate insurance companies!) There's no way I could afford to do this on my own without reimbursment.

I know there are others here who are using daily triptans. I wonder how they are doing.
In the article regarding safety issues, Dr. Robbins asserts:

The primary issue with frequent triptan use, assuming rebound headache is not present, is long-term adverse events. The most likely system for possible long-term sequelae would be cardiovascular. Chronic ischemic changes, valvular abnormalities, or fibrosis are theoretical considerations. There is no evidence to date that long-term use of frequent triptans does produce any of these adverse events. However, this has not been systematically studied. (my emphasis)The number of patients throughout the world who have utilized near-daily triptans is unknown. Until studies on these patients have been done, it is reasonable and prudent to do cardiac monitoring, as well as hematologic tests, on these patients.

Again, I would not recommend a course of treatment for anyone. A feeling of safety is as important as the research surrounding a particular course of action. We are far more than physical beings and we are all individuals. I do wonder at the warnings regarding cardiovascular risks that surround triptan use and wonder if they apply to only a fragment of the population or if they are offered by an insurance industry that doesn't want to pay for large amounts of what is an expensive drug- possibly at inflated prices particularly in comparison to what these drugs cost in many other countries (of course that's another can of worms!)

Since I lost the ability to use daily triptans I have found my condition to rapidly worson, I have used more drugs including "pain killers" which have the probability to do both kidney and liver damage. I also am in greater pain, more frequent pain, and in consequence more emotional pain than I was when adequate amounts of triptans were available to me. (I, like many others, have found preventives useless.)

Love and hope,

Anna

i'm one of those who uses triptans almost daily, and have for several years. no other drugs of any class help my pain...only maxalt and amerge. these two i alternate.

i'm nearly 70 now, and my heart has been checked out thoroughly. along with my 40-year history of migraine, i have 3 sleep disorders, but am unable to stand any of the drugs or machines for those conditions.

but i find that if i sleep better some nights (because of taking higher doses of antihistamines) i need fewer triptans. it's as simple as that.

sleeping pills have been disastrous for me, and have made me worse. so i alternate two or three different kinds of antihistamines. if anyone would like more info about sleep, i can't give you advice, because my body has forgotten how!

5 overnight studies have proven the severity of my problem, and i've somehow learned to cope, and even work part-time. long ago i decided to be engaged in life in spite of the pain. some days are awful, but most days i can function pretty well, and even have some fun. but don't try to take away my precious triptans! dianne

I don't take daily Triptans, but I have more than I am comfortable with.
So far no preventatives worked and sick of being a guinea pig.
I do find that with Triptans I take much less OTC pain killers etc.
If I thought it was ok, and could get a prescription I would have a better life quality with more Triptans than with anything else I have yet been given.
I would like to see if anyone else has a view on this...
Be surprised if they don't....
Thank you for posting Anna, and Dianne for your comments.
P

I was hoping for some more interest in this post...

I'm not a big triptan user but like Pen said, I thought this would be overloaded with comments since a shortage for the month is the biggest complaint with people who use them. However, I thought the fear of rebounds was the reason for not being prescribed enough, not the health risks.

Anna I have been reading all of this stuff you posted.
It is of interest to me if I am to shun any more preventatives.
I cant believe the lack of interest on here.
I guess they just dont work that well for some of us.

Triptans do work for me and it's a thought. The only downside is mine are injectables and I really don't like the immediate side-effects. I wonder what the long term effects would be though...would it stop working or would the side-effects go away or become worse.

I doubt my doctor would go for this though...I think I'm going to have to play by his rules to get this though....

My doctor has no problem with me using daily Amerge. But my insurance sure does. And considering the cost, I'm stuck. There's no way I could afford it. But a few years ago I weaned myself off everything else and only used Amerge. I can't see that they did me any harm and in fact, as I stated earlier, I had a much better quality of life. It was almost like taking a preventive that actually did something.

Anyone look at the articles listed? And there are others you can search for online.

Anna

hi pen just wondering if lack of interest is because over the last year this forum has discussed this at length several times, each time we have people for and against daily triptans, but it is a bit of an open ended book..

I've never used a preventative that worked, BUT using abortives for a preventative has worked for me 100% of the time. I cannot say anything about daily triptan use because I get migraines about 3 times a week and DHE is my abortive of choice. I've used triptans for a preventative on occasion and it has always worked. I've used it when conditions are present to trigger a migraine. Recently I've used DHE in the same way. Worked wonders. It makes sense for me to take a preventive measure vs. waiting for the migraine to begin and possibly escalating which in my opinion is dangerous. So far, this has worked for me every time. Makes you wonder if they know anything about prescribing drugs period.

Before doing this on a daily basis I would check with a doctor but for me who like clock work gets them 3 times a week regardless of "preventatives" or "triggers", I've devised my own plan. I only take the abortive as a preventative if my routine is different and possibly a trigger. Otherwise I can't tell which days I am going to get them so I have to wait until I wake up with one to tell.

The reason I'm replying to this is that it makes me wonder if taking the triptans daily would help a lot of people. Forget long time use. If you are getting migraines everyday what kind of life is that?

Re: Daily Triptans for daily migraine
Anna Today at 2:55 pm

."My doctor has no problem with me using daily Amerge"

i wish that was the case for gps in my local practice, when you mention that they start choking!!! By and large it is still a big no no in much of the uk to go down the route of daily triptans, not sure if it is the cost thats driving this line of thought though.

Anna, thanks for the information, I did find it interesting and printed off a couple of the links. I have to have a clear head to absorb anything remotely technical at the moment. I’m virtually taking daily triptans but don’t feel comfortable with it - perhaps because I’ve too many close relatives who’ve had strokes.

I’m glad it got bumped up again so I can say thank you

Liz

theresae wrote:hi pen just wondering if lack of interest is because over the last year this forum has discussed this at length several times, each time we have people for and against daily triptans, but it is a bit of an open ended book..

I didnt know that Theresa presumably Anna didnt either.

Pen,

It is still possible to search the archives at the old forum. If you want to do so, click on "Old Forum" at the top of this page. You can search the old site using the keywords of your choice. "Daily triptans" as a search term should bring up any threads that discuss the subject.

Chris

Yes, thanks Chris I did know that. Presumably Anna doesn't. Even so lots of new people on here now....and quite a few older ones missing I notice....hmmm
To be honest I don't ever look back....

I've noticed that many of the people who posted often on the old forum post much less or not at all here. Others who hardly ever posted on the old forum post quite often here. Of course there are new folks too, who never posted on the old forum. I'm mildly curious as to why, but not curious enough to try to figure it out.

Chris

Im curious too, but like you said...not that much...LOL