Migraine Medication A "Double Edged Sword"

Patients Who Rely Too Heavily On Pills Wind Up With Worse Headaches, Research Says

(AP)  Those pain pills you think help your migraines? Take too many and you could make them worse.

Overusing painkillers can spin migraine patients into a rut, spurring more headaches that in turn require more pain medication. A very unlucky fraction even get what's called chronic migraine, where they're in pain more days than not, and new research suggests certain prescription painkillers, including narcotics, increase that risk.

Don't misunderstand: Treating migraines, properly, is important. The bigger message is to try migraine-preventing medicines if the tenacious headaches strike regularly - so that you don't fall into the painkiller rut like Rena Cerbone did.

"It was a double-edged sword," Cerbone, 41, of Montclair, N.J., says of a period when only one pain reliever dulled her migraines and then invariably triggered rebound headaches a day or so later. "I was taking Fiorinal on a daily basis just to function."

The caution is timely, as the estimated 30 million Americans who suffer migraines - migraineurs, they're called - often find the holiday season a time of increased pain. Lack of sleep, tempting treats and the stress of travel are common triggers.

The head throbs, usually on one side, anywhere from a few hours to three days. Nausea and sensitivity to light and sound are common. Moving makes it worse. Some people can sense them coming with visual disturbances like seeing pinpoints of light, although lacking that classic "aura" doesn't mean you don't have a migraine.

Fortunately for most patients, migraines are every-so-often miseries. Studies suggest that about a third of migraine sufferers have them often enough to be candidates for prevention medications that can cut the frequency in half. Yet only about 10 percent use them.

And depending on acute painkillers more than a few days a week can signal overuse.

"Most people outside the specialty community are not aware of the concept," said Dr. Stephen Silberstein of Thomas Jefferson University, a spokesman for the American Academy of Neurology. "I think there's an epidemic in the U.S. of patients having frequent headaches, taking their pain pills over and over again," and winding up in more pain.

Overusing any pain medication, over-the-counter or prescription, can cause a rebound headache once it's stopped.

But occasionally in frequent migraine sufferers, the brain gradually becomes more sensitive to pain so they worsen even more. When they're having pain a stunning 15 or more days a month, it's called chronic migraine or "transformed migraine." No one knows exactly how many people get that bad, although migraine specialist Dr. Richard Lipton of the Albert Einstein College of Medicine says some estimates suggest there could be as many as 5 million.

[ozarkbard]

I started having migraines when I was 17, one about every two weeks. I am a classic sufferer; first the vision lights (more like psychadelic water bubbles on a TV screen rather than pinpoints of light), followed by an hour of vomiting, then the headache sets in for about 8 hours, with 2 days of a hangover-type drag afterward.

Over the last 20 years, that has stretched out to one about every two years. I really believe that is because I have been too poor to be able to consistently afford migraine medication here in the United States. Of the hundreds of migraines that I have endured over the past 20 years, I have been able to stay conscious for only TWO... all of the others I end up passing out from the pain after a couple of hours.

20 years of not being able to afford meds in the United States, and simply enduring the pain, has inadvertently allowed my migraines to space apart to a matter of years instead of weeks.

[lgeller11]

I went through a period of 4 months when I was having migraines every other day. I wound up with a neurologist who put me through tests including a CT scan but who found nothing. As a result she put me on a daily cocktail of amitriptylene and metoprolol, which worked immediately. Unfortunately the drugs played havoc with my libido, so she cut the dosages way down, which corrected that problem. The result: in the last 8 years I have had exactly one migraine, and that one was under the severest of stressful situations. It was life-changing.

[barcelonab]

No one medicine has yet been found to work for migraineurs. I have been one for 40 years and have worked with some great neurologist as well as following the medical literature. Neither does either feverfew, chiropractic adjustment or acupuncture work for everyone. It''s also possible to create rebounding headaches by too much so-called "migraine strength" aspirin formulas (which are the same as extra strength aspirin formulas).

Migraine is triggered by different things in different people, also, another reason that''s made it hard to figure out causes. At least medical science now takes this seriously: when I was first diagnosed in the 1960s, it was blame the victim: you were neurotic and a perfectionist.

[kenhamlett]

Feverfew.
If your doctor has not suggested this, change doctors.

Pain killers only mask the problem. I have personally seen natural products stop migraine symptoms cold. I am told not everyone finds Feverfew to be the best natural remedy but so far I have not seen it fail. Your doctor only wants to feed the drug industry. Find what really works. The solution is often simple, cheap and effective.

[barcelonab]

No one medicine has yet been found to work for migraineurs. I have been one for 40 years and have worked with some great neurologist as well as following the medical literature. Neither does either feverfew, chiropractic adjustment or acupuncture work for everyone. It''s also possible to create rebounding headaches by too much so-called "migraine strength" aspirin formulas (which are the same as extra strength aspirin formulas).

Migraine is triggered by different things in different people, also, another reason that''s made it hard to figure out causes. At least medical science now takes this seriously: when I was first diagnosed in the 1960s, it was blame the victim: you were neurotic and a perfectionist.

Why would anyone take these synthetic poisons when there are natural alternatives with no side effects. When it comes to marketing, Big Pharma has no equal. Except for trauma, western medicine has failed us all.

[docpeter1953]

A proper and specific upper neck chiropractic adjustment -preferably done with a mechanical adjuster- and acupuncture once a month cost about $75 - $100.

Worth a try?

Oh, you may become addicted to the friendly folks at the docs office. But the cost there is priceless.

[thealtamiranos]

I couldn''t imagine having a migraine 15 or more days per month. I take Fiorcet for my mild migraines. Amerge is the medication that actually works for me if I catch it in enough time. Fortunately, my insurance covers it after a $40 co-pay. Otherwise it''s almost $300 for a 6 (or 9) pill prescription. My daughter who is at the age I was when I started getting these debilitating migraines has found Imitrex to be very effect for hers. It''s also quite costly just a tab cheaper than Amerge.

[wtw9]

Feverfew, the herb, works best for mirgraines, just a small amount, it''s much, much cheaper too

[wpc0101]

WHAT IS A REAL PAIN IS THE HIGH COST OF MEDICATION. THE GREED OF THE DRUG COMPANIES ARE A SIN.
IMITREX, 9 DOSES IS $254.00

[nottellin1]

Interesting that this piece doesn''t mention Immutrex. Imutrex or Excederin are the onlt meds that work on my migraines and I know other sufferers that concur. Fiorinal & Percocet are so 1980''s. Makes you wonder how good CBS reporting really is???