Migraine Medication A "Double Edged Sword"

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

(AP)  "Chronic migraine is a condition we should be trying to prevent," says Lipton, who also heads New York's Montefiore Headache Center and studied whether particular medicines are linked to this worst-case pain.

The study tracked 8,200 episodic migraine sufferers for a year, and found 2.5 percent worsened to a state of chronic migraine. Those who took two classes of prescription medications - drugs containing narcotics, such as Percocet, or drugs containing barbiturates, such as Fiorinal - were most likely to worsen, Lipton and colleagues reported in the journal Headache. Risk increased with higher doses.

Over-the-counter standbys, from plain acetaminophen to the anti-inflammatories called NSAIDS - ibuprofen, naproxen and their cousins - weren't linked to chronic migraine. The NSAIDS even showed a hint of protection. Migraine-specific painkillers called triptans likewise showed no risk at low to moderate use, becoming a risk factor only after 10 pain days a month.

Some patients will need the stronger narcotics or barbiturates, especially for severe attacks, Lipton acknowledges. But, "the reality is they're overused" in migraines, he says, advising that patients who truly need them limit weekly doses.

Chronic migraine aside, getting out of the medication-overuse rut is hard. In New Jersey, it took Cerbone several tries before she found a migraine specialist who cut her prescription painkiller cold turkey and found a daily prevention medication that has worked since August.

Headache specialists advise:

Ask about migraine-prevention drugs. Choices range from blood pressure-lowering drugs called beta-blockers to epilepsy drugs and certain antidepressants, all of which have side effects to be considered. Some patients even try Botox injections, to quiet overactive nerve endings.

Quit the overused medication, but brace for painful withdrawal. A doctor may advise different short-term medications to help.

Use a headache diary to pinpoint migraine triggers and learn to minimize them.

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Add a Comment See all 11 Comments

by ozarkbard December 23, 2008 4:08 PM EST

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.

Reply to this comment

by lgeller11 December 23, 2008 3:49 PM EST

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.

Reply to this comment

by barcelonab December 23, 2008 2:16 PM EST

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.

Reply to this comment

by kenhamlett December 23, 2008 2:13 PM EST

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.

Reply to this comment

by barcelonab December 23, 2008 1:55 PM EST

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.

Reply to this comment

by December 23, 2008 11:56 AM EST

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.

Reply to this comment

by docpeter1953 December 23, 2008 11:32 AM EST

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.

Reply to this comment

by thealtamiranos December 23, 2008 7:05 AM EST

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.

Reply to this comment

by wtw9 December 23, 2008 5:20 AM EST

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

Reply to this comment

by wpc0101 December 23, 2008 4:27 AM EST

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

Reply to this comment

by nottellin1 December 23, 2008 2:40 AM EST

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???

Reply to this comment

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[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???