Please bear with me as this is a decent amount of information, and I'll try to make it as clear and concise as possible but I'm not at my most lucid.
I take several preventatives for chronic migraine (150mg Effexor XR, 125mg Topiramate, .50mg Nabilone) but I still live with a daily baseline pain level and periodic flare-ups that I manage by temporarily increasing the Topiramate until I get back to baseline (sedation on Topiramate is a problem for me, especially in combo with the Effexor).
This past Monday evening, I had been going on a month with a flare-up, and increasing the Topiramate had not worked. So I decided to go into the ER to see if anything could be done acutely to break the migraine. I had eschewed ER visits after previously having no results from IV infusions of Toradol and DHE, but I was desperate since I'm in a demanding PhD program and my productivity is suffering; I couldn't (can't) tread water any longer after this past month. The doctor laid out his three-step plan to knock out the migraine: 1) Haldol 2) Propofol 3) A steroid
He gave me the Haldol via IV. Pretty quickly I felt loopy. Very out of it and sedated. I had cabbed to the hospital, so I told the nurse I wanted to be discharged, planning to go home and sleep it off. Ever since then, I've been sedated as all hell; can't keep my eyes open. I slept about 17 hours per day Tuesday and my waking hours were spent forcing myself to keep my eyes open.
I'm also taking Modafinil (100mg once per day, except weekends) to combat the sedation from the migraine preventative cocktail. Wednesday I decided I would take that and get back to my normal activities. It was like taking a placebo. Zero effect. I'm used to getting a little boost from that (I wake up quite hungover from the Topiramate each morning as I take 100-125mg at night so taking the Modafinil is like a cup of coffee for me), so this is when I thought "something is quite abnormal here." I went back to the ER, and a different doc ran a blood panel (everything came back normal). He said I should just wait and that while this is unusual, I should start to feel better within 24-48 hours.
Since then I've seen minor improvements. Like I'm able to type this out (with the help of Modafinil) but I'm dead tired most of the day and am sleeping 11 hours still. I plugged my drugs into an interaction checker, and Haldol has major interactions with both Topiramate and Effexor. Further researching the drug, Haldol slows the elimination of drugs that work on Serotonin and Dopamine receptors I believe? My (non-expert) opinion is that the ER doc perhaps wasn't conservative enough with the Haldol dose. So when I took my preventatives that same night, they were eliminated very slowly, so it was essentially like I was taking a mega dose. Then when I took the next day's dose of the meds, the concentration from the day before was higher than it normally would have been. And the next day added to it. So there's a sort of bottleneck, if you will, that needs to be cleared before I get returned to the level of the drug that I'm accustomed to.
Now, my question to all of you (finally! I'm sorry it took me so long to get there) is, does my conclusion make sense at all? And are there any other possibilities you could offer up? I'm doing whatever light work I can this week, but am hoping to get back to my regular schedule next week. And it terrifies me to think this sedation will continue into next week, because if it does I'm going to have to talk to my program about accommodation. And there's a major project coming due soon that I'm afraid this will affect my standing greatly. So I'm in danger of slipping into a dark place if I don't take care of myself, and I'm trying to do just that by finding some hope.
I take several preventatives for chronic migraine (150mg Effexor XR, 125mg Topiramate, .50mg Nabilone) but I still live with a daily baseline pain level and periodic flare-ups that I manage by temporarily increasing the Topiramate until I get back to baseline (sedation on Topiramate is a problem for me, especially in combo with the Effexor).
This past Monday evening, I had been going on a month with a flare-up, and increasing the Topiramate had not worked. So I decided to go into the ER to see if anything could be done acutely to break the migraine. I had eschewed ER visits after previously having no results from IV infusions of Toradol and DHE, but I was desperate since I'm in a demanding PhD program and my productivity is suffering; I couldn't (can't) tread water any longer after this past month. The doctor laid out his three-step plan to knock out the migraine: 1) Haldol 2) Propofol 3) A steroid
He gave me the Haldol via IV. Pretty quickly I felt loopy. Very out of it and sedated. I had cabbed to the hospital, so I told the nurse I wanted to be discharged, planning to go home and sleep it off. Ever since then, I've been sedated as all hell; can't keep my eyes open. I slept about 17 hours per day Tuesday and my waking hours were spent forcing myself to keep my eyes open.
I'm also taking Modafinil (100mg once per day, except weekends) to combat the sedation from the migraine preventative cocktail. Wednesday I decided I would take that and get back to my normal activities. It was like taking a placebo. Zero effect. I'm used to getting a little boost from that (I wake up quite hungover from the Topiramate each morning as I take 100-125mg at night so taking the Modafinil is like a cup of coffee for me), so this is when I thought "something is quite abnormal here." I went back to the ER, and a different doc ran a blood panel (everything came back normal). He said I should just wait and that while this is unusual, I should start to feel better within 24-48 hours.
Since then I've seen minor improvements. Like I'm able to type this out (with the help of Modafinil) but I'm dead tired most of the day and am sleeping 11 hours still. I plugged my drugs into an interaction checker, and Haldol has major interactions with both Topiramate and Effexor. Further researching the drug, Haldol slows the elimination of drugs that work on Serotonin and Dopamine receptors I believe? My (non-expert) opinion is that the ER doc perhaps wasn't conservative enough with the Haldol dose. So when I took my preventatives that same night, they were eliminated very slowly, so it was essentially like I was taking a mega dose. Then when I took the next day's dose of the meds, the concentration from the day before was higher than it normally would have been. And the next day added to it. So there's a sort of bottleneck, if you will, that needs to be cleared before I get returned to the level of the drug that I'm accustomed to.
Now, my question to all of you (finally! I'm sorry it took me so long to get there) is, does my conclusion make sense at all? And are there any other possibilities you could offer up? I'm doing whatever light work I can this week, but am hoping to get back to my regular schedule next week. And it terrifies me to think this sedation will continue into next week, because if it does I'm going to have to talk to my program about accommodation. And there's a major project coming due soon that I'm afraid this will affect my standing greatly. So I'm in danger of slipping into a dark place if I don't take care of myself, and I'm trying to do just that by finding some hope.
