Does anyone else take three different prescriptions to manage the pain of migraines? The neurologist

Posted:: 24 Jul 2010 by lking2619
Topics:: axert, topamax, migraine, migraine prevention, pain, amitriptyline, migraine prophylaxis

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... has me taking 100 mg Topamax and 25 mg amitriptyline to prevent migraine frequency. I also take Axert to manage the pain of migraines, since OTC meds do not help at all (even hydrocodone does not help). The last severe migraine I had lasted for 2 months straight. Now they are less frequent, but the pain still gets so severe that it hurts to lay my head on my pillow. Is this normal?

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Answers (3)

christine...

24 Jul 2010

I checked on the interaction site about these meds. Is there a possibility this "Major" interaction might be the cause of the migraines?

Drug interactions
Applies to: amitriptyline, Topamax (topiramate)

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MONITOR CLOSELY: Certain drugs such as carbonic anhydrase inhibitors and drugs with anticholinergic activity (e.g., antihistamines, antispasmodics, neuroleptics, phenothiazines, skeletal muscle relaxants, tricyclic antidepressants, disopyramide) may potentiate the risk of oligohidrosis and hyperthermia associated occasionally with the use of topiramate, particularly in pediatric patients. These agents may alter electrolyte and fluid balance (carbonic anhydrase inhibition), inhibit peripheral sweating mechanisms (anticholinergic effect), and/or interfere with core body temperature regulation in the hypothalamus (neuroleptics and phenothiazines), resulting in the inability to adjust to temperature changes, especially in hot weather. Also, agents with anticholinergic activity frequently cause drowsiness and other central nervous system-depressant effects, which may be additively or synergistically increased in patients also treated with topiramate.

MANAGEMENT: Caution is advised when topiramate is prescribed with other drugs that predispose patients to heat-related disorders, including carbonic anhydrase inhibitors and drugs with anticholinergic activity. Patients, particularly pediatric patients, should be monitored closely for evidence of decreased sweating and increased body temperature, especially in warm or hot weather. Proper hydration before and during vigorous activities or exposure to warm temperatures is recommended. Patients (or their guardians or caregivers) should contact their physician immediately if they are not sweating as usual, with or without a fever. Ambulatory patients treated with topiramate and agents with anticholinergic activity should also be made aware of the possibility of additive CNS effects (e.g., drowsiness, dizziness, lightheadedness, confusion) and counseled to avoid activities requiring mental alertness until they know how these agents affect them.

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christineATU 24 Jul 2010

I also found this info on Axert.

"Ask your doctor what kind of migraine headache you have. If it is categorized as hemiplegic or basilar migraine, you should not take Axert".

I can not imagine the type of pain you must be in. To have the kind of pain where you can not even function during an attack, must be heartbreaking. You certainly deserve to be as pain free as possible. The main thing is, if these meds are not working, or are just barely working, there must be a reason. Please discuss with your doctor any and all medications that could help you.

My best wishes and I hope you feel better soon
Chris

lking2619 24 Jul 2010

I can not thank you enough for the information. I have an appointment with the neurologist in a few days to go over my meds and dosages, so I will definately be asking some more questions. Thank you for your input.

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masso4169

24 Jul 2010

Hi,

I think it is too much, to many chemicals in your body.

I take topamax--- severe migraines. I take 75mg pm and 50 mg am.

Ask him if you can increase the dose of topamax ( you are on a very low dose) and ask him if you can stop taking all the otc meds.

Well with regards to the pillow , I get you, because sometimes even though I taken the med combined with klonopin... the only way it goes away is when I sleep, I only sleep for like 45min., I suffer from insomnia .I am as you know BP, and my tendency is to be more manic than depressive.

I hope I have been of some help.-

All the best

Andres

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lking2619 24 Jul 2010

Thank you, Andres. I agree that it is a lot of chemicals. I try to avoid taking the Axert (unless I can feel a really bad migraine coming on). I couldn't tell a difference when I ran out of the amitriptyline and only had the topamax to take, so I think I will be talking to my doctor about only taking the one med for "preventing" migraines. The neurologist told me that I shouldn't take otc meds because they were not helping and only increased the side effects. One more quick question if I may... Since you also take topamax, do you have frequent heartburn as a side effect?