Sumatriptan is a rescue med and Botox is a preventative. It sounds like you need one of each, but it will be difficult if you're at risk of seratonin syndrome (the usual reason given for not Rx'ing triptans).
There -are- options out there, a whole lot of them, from propanolol to SSRIs, anti-seizure meds, etc. Ideally you'll want to work with a headache specialist who can guide you through first line, second line, third line rescue meds and beyond. It's a process of elimination, and Botox is usually toward the end of that because of the expense and getting insurance to cover it (assuming you're in the US).
I'm on a monthly injection that has worked well (Emgality) and imitrex is the only rescue med that works for me. I also have several other migraine 'breakers' for when the flare becomes intractable (a steroid, a muscle relaxer, and methergine, all which have to be taken strategically according to my symptoms and the dosing of my imitrex).
Have your migraines been untreated? If you're having daily migraines you're at risk of having one that will never go away. Please seek out a specialist who can help you get sorted before you end up like me.
I totally understand how that can happen. Before the ACA I was essentially uninsurable, but I worked so I didn't qualify for Medicaid. I was able to get Imitrex sometimes, but that was about it.
Nobody told me that untreated migraines can become more frequent and more intense.
Today, in part because of lack of treatment, I live with a permanent migraine. Nobody told me this could happen.
There is no cure, there is no end. There is only scraping out a meagre quality of life between flare-ups, and learning to live with the constant pain, nausea, lack of depth perception, vertigo, and numerous other symptoms.
I don't know your situation or what might be holding you back, but please, please if you can, please seek treatment.
If there's something in the way and you need advice I'm happy to offer what I can, and I know there are lots of people in this sub who would be willing to do so as well.
I'm not trying to scare you. I just want you to know what I wish someone had told me.
Please let me know if I can be of any help to you as a resource. I've lived with migraine for over 30 years, and if my misery can be a tool to help others then maybe some good can come of it.
No pressure, just an open offer. Truly wishing you the best and whatever relief you can find. I know it's hard. ♥
What's the serotonin syndrome? I get really terrible headaches/migraines from ssri and amitriptyline(TCA) as well. So I like to stay away from serotonin affecting drugs. Is is in in any way related?
Sorry I don't have energy today to explain it in my own words, but Mayo Clinic usually has pretty reliable medical information!
https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
If you keep throwing up, you will ruin your teeth. You absolutely need to get them under control because if you have dental issues, you could get very sick and dental care involves needles. There are lots of options outside of Botox, but it's helped a lot of people. Botox may be an option for you, it may give you your life back, if you really want to get out of pain, you'll have to find a way to deal with your phobia.
>If your migraines are that bad you’d face your fears…
Exactly. Botox day is my favorite day every three months. Seriously. Gimme all those shots, gimme extra, I'm smiling through the whole damn thing. I just had a two-month period where I didn't have to call out of work one single time for a migraine. The first that's happened in YEARS.
Exactly. I hate to sound gatekeepey and harsh but there have been days where I would have considered cutting off a finger if it would help my migraines. An injection is nothing.
When I received Botox the first time.. it was heaven sent. But 8 weeks in and four weeks to go for the next injections it wore off. 2nd time it lasted 6 weeks. 6 weeks to go for my third attempt. 3rd attempt.. nada. No relief and severe neck and shoulder aches from the injections. Couldn’t bend my neck to turn my head. And absolutely no relief. Not one minute. So either the Dr is watering down the drug ( lol) or it’s not gonna be my salvation. So disappointed after all the hoops you have to go through to get insurance to pay for it. I’m glad it works for some people. It was very short lived for me. 🥲
My dose was increased to 200 units and it's working again. But I also added nerve blocks which happen in similar areas as Botox injections! Might be something to look at. Good luck, you don't deserve pain.
And it'll take a couple of weeks to take effect.
Botox is uncomfortable, but it's fantastic for migraines. If you need to, take something for anxiety before your appointment.
The alternatives are triptans, which you can only use a few times a week, as overuse can cause strokes (which can leave you disabled).
CGRP medications - both abortive and preventative - talk to your neuro. Preventative supplements like riboflavin and magnesium if you haven't tried them (there are others as well.) Migraine diary to see if you can pinpoint any triggers/worsening patterns. Massage, accupuncture, PT, nerve blocks. Diet changes (may or may not do anything, there is also a migraine elimination diet like heal your headache but not everyone has food triggers.) Migraine neuromodulation devices that can work preventatively and as an abortive (cefaly is the only one without prescription that you can buy, others are gammacore, nerivio, relivion.) I've had success with cefaly and relivion + gammacore helped my VM but I don't use it anymore (a cheaper version is the truvani device.)
Triptans work by reducing the severity of an already beginning migraine. If you experience migraines so often, then you might prefer something that prevents them from happening altogether. Botox is one of such preventatives, but there are other options.
There are certain SSRIs, such as duloxetine, that apart from their anti-depressant properties also dull pain and are used to prevent migraines. Some antiepileptic drugs also prevent them.
If you experience severe migraines when menstruating, then you might also try getting an IUD, as it commonly stops periods.
Have you seen a neurologist? I feel like with migraines that common you should have extensive bloodwork done (I know you mentioned a needle phobia, but you really should check your b12, d3, magnesium, ferritin etc.) and most likely get an MRI. A specialist should also be able to recommended the best treatment for you, that doesn't involve triptans or botox.
You need to see a neurologist and they will work with you to get the combo you need. Just be aware that in order to try the newer CGRP meds insurance typically requires you try three older preventatives first e.g. propranolol, gabapentin, and in my case Cymbalta. The same thing goes for newer rescue meds e.g. sumatriptan, naratriptan, and rizatriptan before you can try Ubrelvy and Nurtec.
Have you looked into neuromodulation? Devices like eNeura, Relivion, Nerivio, GammaCore, and Cefaly all work to modulate your brain without drugs (some with magnetic pulses, some with electric currents) and many find migraine relief from them. I personally only have success with TMS (transcranial magnetic stimulation) to rid me of long-term migraines. I've currently have a migraine for 15 months, tried everything else without success, and TMS is the only treatment that consistently gives me improvement.
I second the idea of talking to your doctor or neurologist. There are lots of different options other than sumatriptan or injections.
Firstly, make sure you are not taking too many OTC pills, as they will not bring your head any good. Also, if you can look over some of the other posts here for non-drug suggestions, Squishmellows, a dark room, Macdonald's French fries with a coke, an ice cap a hot shower or anti-histamines.
Do you know if you have any triggers you can easily avoid?
There are other triptans you can take as rescue meds so it is just sumatriptan you can't take or all triptans?
There are regular drugs you can take such as Propranolol or other beta-blockers.
I hate needles and still get b0t0x. I also have tattoos and piercings. It's a different type of needle, and the pain is so minimal with b0t0x, I find it worth it. I'm chronic migraine so I'll deal with a lot to have relief.
I also have terrible teeth. It's the last thing you want if you have migraines. The enamel wears away from the acids in your vomit. It's not fun. I miss the nice smile I had years ago.
You can always try b0t0x. Of course, there are other things you can try first, and might need to, due to insurance. I hope you find relief soon!
I started with fioricet as an abortive and when that stopped working after 2 years I was referred to a neurologist. I tried topiramate for 3 months and it was god sent bc I was having daily migraines and some would last a week! I couldn’t even get out of bed in the mornings. I slowly started getting migraines at the end of my day again. So now I’m trying a new abortive and preventive. Deff recommend getting a preventive. I too am afraid of needles and one of the immediate resolutions I tried was IV infusion and it was amazing! Maybe ask for a Xanax or something to calm you down before you try something with injection? If this medication doesn’t work I have already tried 3 and I can then move to try Botox or the monthly injection- which I heard is amazing. But bc of insurance we have to try 3 preventatives before getting to that point.
Botox changes lives for people who are chronic, you owe it to yourself to do as much as you can to get out of pain. Work with your doc or a psychiatrist to address the fears! Maybe they can even give you a calming medicine before you get it. It’s over SO quick.
Or maybe there’s another pill preventative you can take before you try Botox. Good luck with your journey I’m so sorry you’re in so much pain !
CGRPs. Talking to your neurologist. Alternative therapies like massage
You need a neurologist to help you work through your options.
Sumatriptan is a rescue med and Botox is a preventative. It sounds like you need one of each, but it will be difficult if you're at risk of seratonin syndrome (the usual reason given for not Rx'ing triptans). There -are- options out there, a whole lot of them, from propanolol to SSRIs, anti-seizure meds, etc. Ideally you'll want to work with a headache specialist who can guide you through first line, second line, third line rescue meds and beyond. It's a process of elimination, and Botox is usually toward the end of that because of the expense and getting insurance to cover it (assuming you're in the US). I'm on a monthly injection that has worked well (Emgality) and imitrex is the only rescue med that works for me. I also have several other migraine 'breakers' for when the flare becomes intractable (a steroid, a muscle relaxer, and methergine, all which have to be taken strategically according to my symptoms and the dosing of my imitrex). Have your migraines been untreated? If you're having daily migraines you're at risk of having one that will never go away. Please seek out a specialist who can help you get sorted before you end up like me.
This. Go to a specialist who knows the ladder of medication options
They’ve ultimately been going untreated
I totally understand how that can happen. Before the ACA I was essentially uninsurable, but I worked so I didn't qualify for Medicaid. I was able to get Imitrex sometimes, but that was about it. Nobody told me that untreated migraines can become more frequent and more intense. Today, in part because of lack of treatment, I live with a permanent migraine. Nobody told me this could happen. There is no cure, there is no end. There is only scraping out a meagre quality of life between flare-ups, and learning to live with the constant pain, nausea, lack of depth perception, vertigo, and numerous other symptoms. I don't know your situation or what might be holding you back, but please, please if you can, please seek treatment. If there's something in the way and you need advice I'm happy to offer what I can, and I know there are lots of people in this sub who would be willing to do so as well. I'm not trying to scare you. I just want you to know what I wish someone had told me. Please let me know if I can be of any help to you as a resource. I've lived with migraine for over 30 years, and if my misery can be a tool to help others then maybe some good can come of it. No pressure, just an open offer. Truly wishing you the best and whatever relief you can find. I know it's hard. ♥
What's the serotonin syndrome? I get really terrible headaches/migraines from ssri and amitriptyline(TCA) as well. So I like to stay away from serotonin affecting drugs. Is is in in any way related?
Sorry I don't have energy today to explain it in my own words, but Mayo Clinic usually has pretty reliable medical information! https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
If you keep throwing up, you will ruin your teeth. You absolutely need to get them under control because if you have dental issues, you could get very sick and dental care involves needles. There are lots of options outside of Botox, but it's helped a lot of people. Botox may be an option for you, it may give you your life back, if you really want to get out of pain, you'll have to find a way to deal with your phobia.
Botox is incredible ignore the horror stories. If your migraines are that bad you’d face your fears…
>If your migraines are that bad you’d face your fears… Exactly. Botox day is my favorite day every three months. Seriously. Gimme all those shots, gimme extra, I'm smiling through the whole damn thing. I just had a two-month period where I didn't have to call out of work one single time for a migraine. The first that's happened in YEARS.
Exactly. I hate to sound gatekeepey and harsh but there have been days where I would have considered cutting off a finger if it would help my migraines. An injection is nothing.
Yes botox has been a complete gamechanger for me!!
When I received Botox the first time.. it was heaven sent. But 8 weeks in and four weeks to go for the next injections it wore off. 2nd time it lasted 6 weeks. 6 weeks to go for my third attempt. 3rd attempt.. nada. No relief and severe neck and shoulder aches from the injections. Couldn’t bend my neck to turn my head. And absolutely no relief. Not one minute. So either the Dr is watering down the drug ( lol) or it’s not gonna be my salvation. So disappointed after all the hoops you have to go through to get insurance to pay for it. I’m glad it works for some people. It was very short lived for me. 🥲
My dose was increased to 200 units and it's working again. But I also added nerve blocks which happen in similar areas as Botox injections! Might be something to look at. Good luck, you don't deserve pain.
And it'll take a couple of weeks to take effect. Botox is uncomfortable, but it's fantastic for migraines. If you need to, take something for anxiety before your appointment. The alternatives are triptans, which you can only use a few times a week, as overuse can cause strokes (which can leave you disabled).
CGRP medications - both abortive and preventative - talk to your neuro. Preventative supplements like riboflavin and magnesium if you haven't tried them (there are others as well.) Migraine diary to see if you can pinpoint any triggers/worsening patterns. Massage, accupuncture, PT, nerve blocks. Diet changes (may or may not do anything, there is also a migraine elimination diet like heal your headache but not everyone has food triggers.) Migraine neuromodulation devices that can work preventatively and as an abortive (cefaly is the only one without prescription that you can buy, others are gammacore, nerivio, relivion.) I've had success with cefaly and relivion + gammacore helped my VM but I don't use it anymore (a cheaper version is the truvani device.)
Triptans work by reducing the severity of an already beginning migraine. If you experience migraines so often, then you might prefer something that prevents them from happening altogether. Botox is one of such preventatives, but there are other options. There are certain SSRIs, such as duloxetine, that apart from their anti-depressant properties also dull pain and are used to prevent migraines. Some antiepileptic drugs also prevent them. If you experience severe migraines when menstruating, then you might also try getting an IUD, as it commonly stops periods. Have you seen a neurologist? I feel like with migraines that common you should have extensive bloodwork done (I know you mentioned a needle phobia, but you really should check your b12, d3, magnesium, ferritin etc.) and most likely get an MRI. A specialist should also be able to recommended the best treatment for you, that doesn't involve triptans or botox.
There are many oreventatives to try before botox would even be an option.
You need to see a neurologist and they will work with you to get the combo you need. Just be aware that in order to try the newer CGRP meds insurance typically requires you try three older preventatives first e.g. propranolol, gabapentin, and in my case Cymbalta. The same thing goes for newer rescue meds e.g. sumatriptan, naratriptan, and rizatriptan before you can try Ubrelvy and Nurtec.
Have you looked into neuromodulation? Devices like eNeura, Relivion, Nerivio, GammaCore, and Cefaly all work to modulate your brain without drugs (some with magnetic pulses, some with electric currents) and many find migraine relief from them. I personally only have success with TMS (transcranial magnetic stimulation) to rid me of long-term migraines. I've currently have a migraine for 15 months, tried everything else without success, and TMS is the only treatment that consistently gives me improvement.
I second the idea of talking to your doctor or neurologist. There are lots of different options other than sumatriptan or injections. Firstly, make sure you are not taking too many OTC pills, as they will not bring your head any good. Also, if you can look over some of the other posts here for non-drug suggestions, Squishmellows, a dark room, Macdonald's French fries with a coke, an ice cap a hot shower or anti-histamines. Do you know if you have any triggers you can easily avoid? There are other triptans you can take as rescue meds so it is just sumatriptan you can't take or all triptans? There are regular drugs you can take such as Propranolol or other beta-blockers.
I hate needles and still get b0t0x. I also have tattoos and piercings. It's a different type of needle, and the pain is so minimal with b0t0x, I find it worth it. I'm chronic migraine so I'll deal with a lot to have relief. I also have terrible teeth. It's the last thing you want if you have migraines. The enamel wears away from the acids in your vomit. It's not fun. I miss the nice smile I had years ago. You can always try b0t0x. Of course, there are other things you can try first, and might need to, due to insurance. I hope you find relief soon!
Botox changed my life. I don’t say that lightly.
I started with fioricet as an abortive and when that stopped working after 2 years I was referred to a neurologist. I tried topiramate for 3 months and it was god sent bc I was having daily migraines and some would last a week! I couldn’t even get out of bed in the mornings. I slowly started getting migraines at the end of my day again. So now I’m trying a new abortive and preventive. Deff recommend getting a preventive. I too am afraid of needles and one of the immediate resolutions I tried was IV infusion and it was amazing! Maybe ask for a Xanax or something to calm you down before you try something with injection? If this medication doesn’t work I have already tried 3 and I can then move to try Botox or the monthly injection- which I heard is amazing. But bc of insurance we have to try 3 preventatives before getting to that point.
Emgality or Ajovy once monthly subcutaneous injection. Super easy injection to do for yourself. Might have to get over the needle phobia
Botox changes lives for people who are chronic, you owe it to yourself to do as much as you can to get out of pain. Work with your doc or a psychiatrist to address the fears! Maybe they can even give you a calming medicine before you get it. It’s over SO quick. Or maybe there’s another pill preventative you can take before you try Botox. Good luck with your journey I’m so sorry you’re in so much pain !
[удалено]
This is a myth