I have lived with what I now realize to be migraines for 31 years.
A neurologist put me on Maxalt, and for the 1st time, I feel like living again. I still have good days and bad days, but the bad days are "great" considering what I was experiencing in the past.
Any decrease in the 10 mg of Maxalt b.i.d. results in the identical symptoms returning. I have too many to mention, but it includes most of the severe symptoms of migraines.
I know that patients with migraines refractive to preventatives have been using triptans on a daily basis up to 6 years w/o any identifiable medical issues.
I'd like opinions related to "long term triptan usage"; and NOT why I should not do it. I can't take the option of living in the old-style pain ever again. And, are there any MD's in the Dallas area (I'll be down there within 45 days - for good) who support the idea of long term triptan usage for refractive migraines. I understand the cardiovascular concerns, but my quality of life requires daily triptans........I'm in excellent condition and have probably added about 10 or 15 pounds of muscle while dropping my waist size by at least 3 inches. (For what its worth!)
I'd appreciate feedback that addresses my question.
Please do NOT advise me as to why I should not use triptans on a long-term basis, unless you can live with the pain and all of the related symptoms. Thanks.
Thanks, Ed in NY
Ed,
Hello and welcome!
You said, "I know that patients with migraines refractive to preventatives have been using triptans on a daily basis up to 6 years w/o any identifiable medical issues." Is this anecdotal or can you provide published data on this? If you have a published reference, I'd be very interested in it.
Thanks!
Teri
There is a 2003 study done by Dr. Robbins (not mainstream per my neurologist - but he gets results) that analyzes 119 patients - the patient age and usage (by number of months) is charted; I found it somewhere in Robbin's writings on the net - you may want to key in on Robbins (he is in IL) and the 2003 triptan study - he also did an earlier one on 59 patients, I believe. HE also challenges the rebound assertion of triptans, adding that Excedrin has as much or more of the socalled rebound effect. (this may be in a Q&A interview!)
I know there have to be a few MD's who practice accordingly; its just a challange to find them, as they usually do not need new patients.
The Problem appears that almost ALL MD"S do not support usage and fail to recognize that patients that suffers on a daily basis may have no alternative - there is such a thing as refractive migraine. I use Maxalt every 8 to 12 hours...though I try to stretch it as long as possible. At times, I'll try to live with the pain and pressure - and go 13 to 16 hours - but it's simply not worth it. The REAL issue is cost; and HMO's are real problems here; but these battles CAN BE won.
Some days are fantastic...others are OK (great by the pre-triptan standards)...It also seems that the weather...either cold and damp or rainy days also bother me. (I used to think it was allergies and sinus issues - Welsome migraines!)
IF you can't find it, I may have a copy in my old emails....post again and Ill see what I have...if U need it...It may also list the web address - Ed
Ed,
If I don't find the data shortly, I'll just email Dr. Robbins. He'll point me in the right direction. I am already somewhat familiar with that study. Unfortunately, I could point you to many others that went the other way, demonstrating triptan rebound. Sadly, this data abounds in the journals Headache and Cephalalgia.
Still, one size does not fit all. Medication overuse has been shown to be a factor in 80% of refractory Migraine, but that's not 100%.
I don't, of course, know what you've tried, but there's some research on IV therapy for refractory Migraine that might be of interest to you. Take a look at the article IV Treatment of Refractory Migraine. There's a copy of the research poster associated with this HERE. In November, I spent a week observing in Dr. John Claude Krusz's clinic in Dallas. The results of IV therapy that I observed were exceptional.
Teri
Thanks Teri.
My mind is always open; I understand rebound.......but I also understand that I have operated under tremendous pain and related handicaps for more than 3 decades.
At this point, I believe that rebound has been ruled out and is out of the picture.
In staring over, I also have to prioritize; when the plane leaves, and we reach altitude, I have to jump. This is the only certainty I have.....I have to pull the cord. I do not have the luxury of time, nor do I have the best HMO.
I may sould bold, and I am; but I also respect the feeling of fear; and I listen to those who I may not necessarily agree. I can also smile when I do it, as I am with this great big grin on my face as I'm completing this reply. I've enjoyed your comments, Teri. We'll have to do this again!
SIX MONTHS ago, this would have been impossible. Life was a struggle then; life is simply fantastic now. It's simply great to be alive. I can't remember when I ever said that before. I may be walking in a minefield, but I will get to the other side, however slowly, taking one step at a time.
Ed
Hi there Ed,
Just wondered how things are for you know and if you are still on the constant Triptans....
I hope things are better.
P