Med-Go-Round

Right now my prophylactics (daily meds to minimise (in theory) the severity & number of migraines) are:

Depakote, 3x150mg --it's an anti-epilepsy drug

Elavil, 1x1000mg --it's an anti-depressant

Vitamin B2, 1x500mg

Magnesium, 1x500mg

I couldn't tell you how any of them are working. I couldn't even tell you side effects. I think I'm just used to feeling weird, one way or another.

This particular mix is a few weeks old. Drugs I've come off of include:

Neurontin

Topamax

Wellbutrin

Cymbalta

Probably more. It's hazy by now. But basically anti-depressants and anti-epileptics. There is another popular option of beta blockers, but I have crazy low blood pressure (escort opines all my migraines can be fixed with some good old NaCl, but having had a bag of chips yesterday, I don't know if I could live that way...) so those are out.

Abortives, drugs taken once the migraine is on include:

Imitrex (15 or so a month)

Maxalt (15 or so a month)

Frovatriptan (9 or so, so far)

Eh. None of them work reliably, but they're better than nothing so I keep going through the mechanics.

My insurance company hates me. I think they would rather I took no more than 9 of just one of those triptans a month.

Hey, me too. But let's accept the impracticality of that. I had to get dispensation to fill 18 Maxalt and 18 Imitrex. Then I get prescribed 18 Frovawhatsits, and they're just not happy. Hell, even for the Imitrex and Maxalt I have to fill them twice a month, instead of 18 at once.

I figure they're a lot cheaper than ER visits, but I'm not in charge here.

Rescue medications (taken in case the prophylactics allowed the migraine to start and the abortives failed to stop it--mostly I'm trying to be unconscious):

Percocet

Flexoril

Ambien

I'm not on any of them these days. I had an initial 50 pill presciption of Percocet, plus assorted leftover Flexoril and Ambien. I tossed the leftover drugs in a fit of toeing the line, and my neuro won't give me a prescription of Percocet in a high enough dosage to even touch my pain. So I have nothing--if I need rescue, I either suck it up or call for a ride to the ER.

ER drugs (the first 5 are the migraine guru-recommended combo):

IV Compazine--massive anxiety attacks. Can't take this unless it's with

IV Benadryl

IV Toradol--it's an anti-inflammatory

IM Imitrex (the abortive, but shortcut)

IV Dilaudid--I've had up to 10mg, and that was just awful, and there was no added relief once I went past 6. Escort won't let them give me more than that.

IV Demerol--just no. That was horrible. Escort had to keep me talking throughout the paltry 2mg because when I stopped talking I fell asleep and then woke up with a horrible start because I'd stop breathing

IM Dilaudid--yeah, that was by mistake because the IV slipped. So very miserable.

IV Phenergan--sometimes given to me when escort informs them of the adverse reaction to compazine. Don't have a clue what it does.

The dilaudid has anxiety side effects too, and I've finally discerned (with some reading up) that the anxiety attacks I have the day after are probably med-related. Doesn't make them go away, this knowledge. But it does make them a wee bit more bearable.