New Doctors

I am so sorry to hear what you have been going through. Generally the triptans (Relpax followed by Frova) work for me, but when I've reached my maximum dosage of those, my prescribed rescue of Norgesic (Orphenadrine Citrate with Aspirin and Caffeine) taken with Vistaril (for the nausea) works amazingly well. Maybe you could ask your doc if a combination med like this would be appropriate for you.

I've also experienced problems with Tramadol when taken too close to the Triptans--seratonin syndrome--scary. I don't bother with it any more.

Good luck to you.

Hi, Lisa,

I really hate to see that you're still going through such a tough time. Let's see if I can give you any information that can lead to help...

You said, "I soon found out the bad side of a headache specialist." Not really. You found out the bad side of Dr. Couch maybe, but being in the office only two days a week is not common among Migraine specialists.

It's very important to realize that neurologists aren't necessarily Migraine specialists. Thinking they're one in the same has slowed down many of us in our search for help and better care. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists. I looked for information on Dr. Merkey, and nothing I found indicates that he's a Migraine specialist.

I fully understand your frustration with not getting more help from Dr. Merkey. Referring you back to your primary is unlikely to be very helpul. Most primary docs don't keep many injectable medications in their offices.

For the record, I totally agree with you that we need to have rescue options set in advance. Actually, that's a question that I recommend asking ANY new doctor at the very first appointment, and to me, it's a deal breaker. If a doctor isn't going to put a plan in place for me when I need help with a Migraine that doesn't respond to my regular medications (and I mean during office hours, after hours, evenings and weekends -- any time), then he's not going to be my doctor. It's that simple. Take a look at the Migraineur's Guide To a Successful Doctor's Appointment for more information.

As for the inssue of tramadol and antidepressants, most Migraine specialists do not agree with what you were told. I take an antidepressant daily, both for depression and for Migraine prevention, AND I have a standing prescription for tramadol for breakthrough arthritis pain. Also, the prescribing information for these medications do NOT say that they shouldn't be used together. It says that patients should be made aware of the symptoms that could indicate problems and report them to their doctors immediately. The same thing applies to triptans such as Imitrex, Maxalt, Zomig, etc. You can find more on that in Antidepressants, Triptans, and Serotonin Syndrome.

I hope some of this helps.

Please keep us posted?

Teri