Daily Migraines... Topamax and Percocet as preventives?

Question: Daily Migraines... Topamax and Percocet as preventives?

Answer:

Full Question:

Hi, I'm a 30-year-old male who's been suffering with twice daily (sometimes three times) migraines for 10 years. Right now, my Neurologist has me on Topamax and Percocet as preventatives and Imitrex and Zomig as needed as migraine fighters. I've had MRIs, MRAs, and CAT Scans - all which have shown only that one of my vertebral arteries is slightly smaller than the other - giving my neurologist nothing to help with the treatment of my migraines. I can no longer hold down a job, I can't get to sleep at night, and sometimes the migraines wake me up when I do finally get to sleep. I am on two different sleeping medications - Ambien and Trazodone. When I get a migraine I have many of the typical symptoms - deep throbbing pain in left or right front quadrant of my head that then spreads to my entire head. Accompanied by blurry vision, sensitivity to light, sound, and odors, vomiting, lack of balance, and diminished brain function. When I get a migraine I feel like my head is going to explode or that I may die at any time. Since the migraine fighting medicine still works to relieve the migraines my neurologist does not want to change this approach. He added to this that I start a new diet to detoxify my body - eliminating all caffeine, sugar, dairy products, spices, carbohydrates, alcohol, foods with preservatives, most fruits, and some vegetables. This diet has helped me lose 20 pounds, but hasn't helped my migraine problem at all. I'm at the end of my rope and I feel like I can't go on living this way. Do you have any suggestions for what about and how I should be talking to my neurologist to turn my migraine problem around? Can you recommend any better migraine preventatives for a person in my position? Thank you, Brian.

Answer:

Dear Brian;

One thing that may very well be compounding your problems is the use of Percocet for a preventive. Percocet is not a preventive. Percocet is a pain medication, and using it more than two or three days a week is highly likely to cause rebound headaches in most people. See:

Arghhhhh! Rebound Headaches!
You have a headache. Taking medications is one of the logical things to do. There is something to consider before you take that medication though -- the dreaded rebound headaches. They're caused by taking medications too often. Sometimes just taking a drug for two or three consecutive days can cause rebound.

If you've been taking the Topamax for a few months with no improvement, it's probably time to change the dosage or change to a different preventive medication. There are many, many of them to choose from. If you're not making progress with your current doctor, consulting a Migraine specialist may well be the best thing you can do for yourself. It's really impossible to recommend specific medications via the Internet. That should be done only after reviewing a patient's medical history and symptoms and performing a complete examination.

Good luck,
Teri Robert and John Claude Krusz

____________
To visit our directory of recommended specialists and clinics, click HERE.

To visit our forums for an exchange of information and support, click HERE.