Stimulants are a terrible idea for migraines. I hated pizotifen. It's rarely prescribed anymore. Have you tried trycilics? I'm on nortryptaline (high dose) and it's done wonders for me.
And opiates (DHC) can cause migraines. Is your doctor crazy?
Opiates can cause migraines - maybe increased cranial pressure? - but when an attack hits, they can also distance you from the pain. The most effective treatment, for me, has been sumatriptan + dhc + an anti-emetic (usually buclyzine) + low-dose NSAIDS. Believe me, when the right side of your head's about to explode and the sumatriptan didn't work (usually because you've taken it too late), 120 mgs of dhc chased with soda and migraleve (500 mgs acetampinophen/paracetamol, small dose of bucylizine + 8mgs codeine) makes the difference between sitting in pain in a dark room for half an hour till the meds kick in and losing a whole day to agony that straight-up Ibuprofen or acetaminophen/paracetamol barely dents: without an opiate at hand, there's the risk of incapacitation. I can't afford - literally - to be unfit for work, day to day. I'm in the EU, the economy's been bad for years, my field's competitive: and I'm freelance. Two-three times a year, attacks come in on a daily basis - sometimes 2/3 times a day. I don't have time to fuck around.
There's an offer of surgery that
might ameliorate the problem, but it isn't guaranteed, and I'd have to walk around with my face bandaged for up to six weeks. Now, I'm not much to look at: but I think I'm better off, at meetings, not looking like a mummy. But to be honest, yeah, my doctor is fucking crazy. He wrote me stupid scripts till I caught him out in a few careless prescriptions without proper warning, and then he pretty much allowed me to treat myself (I know a few shrinks socially, I was primed on how to put it. If I'd taken the pitzofiten/metocolopramide cocktail he'd given me, I could have undergone extreme personality change, tremors, weight gain, aggression, depression and tardive dyskenesia, plus addiction to dysphoric meds. So I cornered him, and he accepted my opinions/preferences for a while...then read a few papers that claimed modafinil in moderate doses can treat sleep apnoea - which exacerbates migraines - and isn't strong enough to cause them. But I think, on reflection, I better find another doc - so thanks for responding, it was the push I needed. The worst thing about it all, and I realise this ain't exactly serious. is that I have all the classic migraine triggers: red wine, red meat, dark chocolate, tobacco.
I love to smoke, eat beef in many forms and prefer dark chocolate.
And can live with an excuse to take painkillers.
As to noratryptaline, I'm not familiar with it...and it makes me think of tryptamine anti-depressants, which I've seen zombify friends. But I'll look into it.
I guess I started this thread because I know my doc was following an increasingly widespread practice of using the modafinils for migraine purposes, because of their vasodilatory properties - sinus shit (like my nasal polyps) exacerbates migraines, throw in sleep anpnoea and low-dose kinda makes theoretical sense. But it sure hasn't worked for me, and I've needed benzos (migraine-neutral) when armodafinal wears off.
I'm a Jew. A fucking Jew. Could I bless red wine and bread and light the candles tonight? Nah, I had to drink
white wine, or I would have been hitting max doses on ibuprofen just to get the codeine blended in these pills. Sorry to go on at such length: I'm lucky to be somewhere one can easily and legally be equipped to take quite large amounts of codeine and anti-emetics. But I tried the armodafinil this morning, and have finally decided it's completely useless. I hate throwing pills away, but these ones are going down the toilet.
