Anna Nicole Smith, Topamax, Methadone, Elvis, & Karma

Patient Expert
Anna Nicole Smith

The news has been plentiful and redundant lately with stories about Anna Nicole Smith's life and death. Stories about her baby and who the father might be, stories about the death of her son, and more. Some so-called journalists have seen fit to report that she was taking Topamax, which is of interest to some Migraineurs because Topamax is sometimes prescribed for Migraine prevention. But did these journalists bother to do the research to see why she was taking Topamax? No, those whose reports I've seen did not.

It didn't take much work to discover that Anna Nicole was indeed taking Topamax for Migraine prevention. In fact, I've seen at least one interview with her where she discussed her Migraines. Now, human nature being what it is, the Topamax isn't the only thing in her medical history that started tongues wagging and fingers typing. She had also been prescribed Methadone for chronic pain. Too many people associate Methadone only with substance abuse, detoxification, and rehabilitation. In reality, Methadone is a highly effective pain management medication, which was it's original use.

All the news reports and online discussions made me think about Elvis Presley. I know that may seem strange, but I can explain why. There were more than abundant reports about Elvis's behavior that made people jump to the conclusion that he was "using drugs." Results of his autopsy showed   Demerol, propranolol, LSD, and antiemetic medications in his bloodstream at the time of his death.

LSD!? People were properly shocked and mortified, but then he was a rock and roll star, so many people readily believed the worst. What a sad legacy for such a talented young man. Let's take a brief look at those medications and why they were PRESCRIBED for Elvis. Elvis had... drum roll, please ... intractable Migraines, Migraines that don't respond to treatment. He hadn't taken LSD. He had taken DHE-45 (dihydroergotamine), a Migraine abortive medication. Both DHE and LSD are ergot derivatives, and even today if your blood is screened for "drugs" after you've taken DHE for a Migraine, you will test positive for LSD. There was Demerol in his blood because he'd taken it when his Migraine abortive, the DHE, failed -- just as I do today. He had taken antiemetics because DHE typically causes nausea, and propranolol had been prescribed for him as a Migraine preventive. If you'd like to read more about Elvis and his struggle with Migraines, check out Elvis & LSD? No, DHE for Migraine!

As Migraineurs, part of our struggle is being misunderstood and misjudged. Since Anna Nicole's death, I've been surprised and disturbed by some of the discussions I've read on Migraine message boards where people were guessing about why she was taking Topamax. Some people suggested that perhaps she had Migraine disease, but more guessed that she was taking it for the weight loss side effect. Sigh. It really surprised me that people who are the victims of such judgmental attitudes would say such things themselves. It was these discussions that really brought to mind the parallel between Anna Nicole and Elvis.

I'm not trying to be high and mighty or holier than thou here, but I am trying to make people think. If we who experience such ignorance ourselves say such things, how can we expect better toward us from other people? Should we be a bit concerned about karma? Should we remember "what goes around comes around?"

Anna Nicole Smith was famous. She was a celebrity. She was also a woman, mother, human being, and a Migraineur. She was one of us. Rest in peace, Anna Nicole, rest in peace.