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  • BDD Moderators: Keif’ Richards

Headache/Migraine Painkillers - Possible Substitutes

If the doctor gives you gabapentin, just remember you HAVE to give it a couple of months to know for sure if it's working. Good luck!
 
Sounds like these folk are taking care of you well. :) (Thanks madog!)

OP: The first reply to your thread is the one I'd pay most attention to: Cluster headaches are, if not entirely, damn near proven to relieve cluster headaches. Note: Do NOT be on any serotonergic drug / medication if / when you try this. Amitriptyline falls under this category - anything with activity on serotonin is important to avoid.

Beyond that - lose the Tramadol. It's an SNRI as an aside to a very poor painkiller. It's analgesia only builds throughout the day; it offers no immediate relief. I was taking up to 400mg/day (point where seizure threshold is lowered significantly) and would only have noticeable drop in pain levels after dinner-time (roughly 5-7pm, depending on who knows what - maybe the food kicked up my metabolism?).

Amitriptyline isn't very good for you long-term either: it's NDMA antagonism is similar to PCP, and so is its means of damaging the brain.

I would definitely try out gabapentin / pregabalin. I would personally go for the latter of the two, as it's the later-developed-more-effective option of the two. However it's only offered by Pfizer as Lyrica, and there are no generics available. We're not allowed to talk prices here, but let's say that it's several times the cost of my hydrocodone Rx (non-insurance prices). As madog said, it takes a while to kick in. It's been over a month (5 weeks or so) and my Lyrica is finally working for me. It actually relieves the majority of my pain if I'm not doing anything strenuous. (My issue is basically mystery back pain due to Lyme disease / who knows what [tested negative for arthritis so far].)
 
Pjkt2501 said:
Sounds like these folk are taking care of you well. :) (Thanks madog!)

OP: The first reply to your thread is the one I'd pay most attention to: Cluster headaches are, if not entirely, damn near proven to relieve cluster headaches.

Beyond that - lose the Tramadol. It's an SNRI as an aside to a very poor painkiller. It's analgesia only builds throughout the day; it offers no immediate relief. I was taking up to 400mg/day (point where seizure threshold is lowered significantly) and would only have noticeable drop in pain levels after dinner-time (roughly 5-7pm, depending on who knows what - maybe the food kicked up my metabolism?).

Amitriptyline isn't very good for you long-term either: it's NDMA antagonism is similar to PCP, and so is its means of damaging the brain.

I would definitely try out gabapentin / pregabalin. I would personally go for the latter of the two, as it's the later-developed-more-effective option of the two. However it's only offered by Pfizer as Lyrica, and there are no generics available. We're not allowed to talk prices here, but let's say that it's several times the cost of my hydrocodone Rx (non-insurance prices).
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I aim to please! =D Hopefully we've helped!
 
I have approx 3 very severe migraines by month (very strong, impossible to work) I'm using SUMATRIPTAN (one tab of 100mg) at the start of the migraine + only 500mg of paracetamol (it is very weak but for me it seems to work very much when I add this small quantity of paracetamol (acetaminophen) . Then after 2 hours I eat one more tab of Sumatriptan 100 mg or 50mg (depends of the pain level) 2 hours after the first tab.

For me Sumatriptan is THE REMEDY. We are all different, migraines are very complex therefore it cannot work for you. for Some people sumatriptan has no effect.

Just for info : Tramadol (or other weak opiates : codeine, DHC) has absolutely no effects on my migraines type and I don't want to try hard opiates on my migraines)

Never tried gabapentin because Sumatriptan works then i will not change my medication.
 
And after a small absence, I return. :)
I've yet to change to gabapentin, though I did have a chat to my doc about it. She said she'd have a think about it and considered it a possible trial after increasing the topamax a little more (which is now at 100mg/night). She also prescribed me some 30mg Codeine phosphate as a trial replacement for the Tramadol, which I was a little hesitant towards. Seems my hesitance was reasonably well-based, as the codeine worked for a much shorter period of time (Guessing this is because the tramadol is extended-release), caused some severe itchiness (which I hear is a common side effect) and also didn't work as well. My new plan consists of these actions:
  • Definitely Look into LSD treatment.
  • Possibly look into Sumatriptan again, combining it with paracetamol.
  • A few other things, will edit post later tonight... >.<
~Pathos
 
DeeJaySwayD said:
www.clusterbusters.com

psylocin and lsd therapy. at approx 10th the rec dose.

it works, i have tried it. i used to get 3 month long headaches. it keeps them away up to a year usually....sometimes permanently for some users. ill get you some more info after some research.
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Interesting you say that. My friend does LSD as migraine prevention as nothing else works for her. (She has a strange metabolism that does not accept most modern pharmaceuticals.) She says that the medicinal effect of the LSD won't happen unless she has full on visuals. She's tried lower doses and the prevention doesn't work. Do you have any experience with that?
 
^I don't have any personal experience, but there are several documentaries that discuss the process and possible reasons for the effectiveness. Typically I see psilocybin used in this manner.

The neurochemistry is well beyond my personal understanding, however from first hand experience, a VERY profound LSD trip (~400ug? hard to guess really) leaves a lasting change in the head / brain. For me - I'm like a model citizen for several months. Perhaps that's the introspection in my situation however.

Good luck to the OP!
 
The mother of one of my buddies started to have cluster head aches not long ago, real bad. She never tried any drug other than pain killers such as tramadol . She got to a point where she had given up any medicine and thought this head aches were going to be part of her life from now on. After talking about it and watching (inside lsd- nat geos doc) , she decided to take it (2 hits). That was 4 months ago , (she wants to trip again but for different reasons) the sudden pain is gone.
 
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I have found that when I gave up aspartame in all its various forms in my diet, my migraines virtually disappeared. To my system, that stuff is POISON. When I do get a rare migraine, I find that sumatriptan does the trick
 
@CarmelaSoprano Hmm, interesting that yet another person mentions sumatriptan. When I tried it, I had absolutely no effect from it, even after trying varying dosages in varying situations... Though, I may give it another go in future. I do plan to see my doc again tomorrow, and I plan to get off the topamax completely and switch to gabapentin (Yes, they considered it a good idea to keep me on topamax for this long) asap to test at least that out. I do also want to try the lsd therapy, as it looks very promising. I do have a question though, in relation to painkillers now:
  • What is recommended over tramadol (As my body seems to have built up a pretty strong resistance to it - head pains totally resist a 100-400mg dose, strongly interfering with my schoolwork now.)
  • I've read elsewhere that Oxycodone may be a could choice, though I thought I should ask.
  • What do you think?

Thank you everyone for your help so far, it's been very enlightening! :D
 
Opiates are a bad choice as A LOT of chronic migraine sufferers only have it due to medication overuse. Opiates are usually responsible for that. They give me headaches through my meds, when nothing else does.

Gabapentin will hopefully really help. It's a shame but docs do have to give it about 3 months to see if a drug for migraine prevention rather than just pain releif is working. Don't cloud that with opiates and take OTC painkillers as little as often. My neurologist throught my ibuprofen use was making mine worse using it once a week!
 
Interesting that you say that madog, as it really does seem that opiates are the only painkillers to have given me any relief in the past at all. (Then again, the only opiate painkillers I've actually tried are reasonably low-strength codeine and 50mg tramadol tabs.) Other than that, no other painkillers have given any relief at all (Literally, not even a flicker), lack of painkillers (Several weeks-a month+ without) was even worse - had a HUGE impact on schoolwork; this is my main concern. I also think I should strongly reiterate the general gist of what my doctors/specialist/neurologist continue to tell me; "We still aren't sure if these are headaches or migraines, or exactly if they are either of the two at all. They could be something different altogether." I've had MRI's; they've shown nothing, eye tests; again nothing, chiropractic checkups; yet again nothing. Everything seems to grind to a dead stop, and it's a bit of a worry.

tl;dr: My main concerns right now:
  • Finding painkillers that will at least allow a degree of control over the worst of the headaches, so that my schoolwork is able to be completed.
  • Finding some sort of prevention method that could in theory lessen the intensity/frequency of the head pains that I get.

I do apologise if it sounds like I'm asking a lot here. I think what's getting at me most of all at the moment is that my teachers think I'm a dick for not being able to complete some of my work. :p Anyway, thanks for reading.
 
There are like 7 different triptans on the market right now for various types of migraines. You should try a few of them, as each one seems to work differently for different people.

Opiates have a rebound phenomena, meaning that if you take them more than like 3-4 times a month, they actually start to cause migraines.


I've suffered from migraines for my entire life and have tried nearly every treatment. PM me if you'd like more in-depth info. I'm not big on posting about my personal medical situations on public boards.
 
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As above ^ I find if I try to get high on opiates 2 days in a row it can lead to some of the worst headaches I've had. Then again, I have been diagnosed as chronic migraine/transformed migraine, though until very recently I was in your shoes, meds weren't helping and until I insisted I wasn't even sent for tests. Had a CT scan that came back clean.

Turns out my doctor was being too cautious with my doses. Although we had just started me on a new med which seemed to be helping a little for the first time ever. Neurologist trippled my dose right there and then, without even waiting to see. And I am so glad she did. My head is clear for the first time in 5 years. I was in pain every day and would fear noise for risk of making it worse.

What I am warning is that give the gabapentin a chance, I know the opiates help but try to give the gabapentin a month on its own so that the result isn't clouded. I am sorry you don't have a diagnosis. Maybe try shrooms and if they work you know its cluster headaches?! Lol ;)
 
Hmm, apparently seems that hydrocodone isn't even available in New Zealand any more, due to abuse. (Not to mention, the Doc won't put me on Oxy due to the strength of it, which didn't really surprise me all that much.) Might have to dip into a few preventive strategies to see if they work before I try any new painkillers then, heh. Though, I do hope my results don't suffer as a result. I can't remember if I mentioned this yet, but I'm a final-year secondary school student. I'm taking scholarship-level English, Mathematics with Calculus, Electronics, Classical Studies and also Chemistry. Only the five, but I wish for none of those five to suffer as a result of my current situation.
 
^If anything, I think therapeutic usage of opioids will incease academic performance, due to reduction of pain (increasing focus), and due to the Dopamine boost. It's the addiction and withdrawal that will mess with your grades.

Some find low-dose opioids as good as amphetamines for focus/ADD relief.
 
Ergic-

If you read the other postings you will see that for someone with chronic headaches regular use of opiates is a very bad idea.

POT-

Have you been started in gabapentin yet?
 
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