Posted by ed_uk on May 12, 2005, at 16:28:03
In reply to Re: Headaches: codeine, posted by Nickengland on May 12, 2005, at 13:56:15
Hi Nick!
>I did find it helped relieve the headache, but only because I was distracted by the relaxion it produced.........
Although opioids can be very effective for certain types of pain, they are often not particularly effective for headaches/migraine. They sometimes cause headaches!
>ibuprofen, in general ive found paracetamol useless........
Ibuprofen and other NSAIDs are often effective for migraine, paracetamol is less consistently effective for this type of pain.
>long-term damage ibuprofen can cause........
Severe side effects are unlikely if you use ibuprofen intermittently. The maximum over-the-counter dose (in the UK) is 400mg three times a day because it has a relatively good safety record at this dose. Doctors sometimes prescribe up to 600mg four times a day or 800mg three times a day. Side effects are more likely at these doses. Peptic ulcers are usually more of a concern than kidney damage. Try to find the minimum dose which controls your symptoms.
>Any problems with bipolar and the triptans because of this serotonin action?
I haven't heard of there being any problems. Perhaps some bipolar people on p-babble have used triptans and can tell you how they responded.
Triptans are suitable for occasional use only ie. in the treatment of an acute moderate to severe migraine attack. Regular use of triptans can cause a 'rebound headache' when the drug wears off.
Triptans available in the UK include............
almotriptan (Almogran tablets)
eletriptan (Relpax tablets)
frovatriptan (Migard tablets)
naratriptan (Naramig tablets)
rizatriptan (Maxalt tablets and wafers)
sumatriptan (Imigran tablets, injection and nasal spray)
zolmitriptan (Zomig tablets, orodispersible tablets and nasal spray)Surprisingly, low doses of various antipsychotics can be effective in treating both the pain and the nausea/vomiting of severe migraine attacks. In the UK, the antipsychotic/antiemetic prochlorperazine is available without a prescription for the treatment of migraine attacks. The brand name is Buccastem- the tablet is placed between the upper lip and gum and left to dissolve. Although it is sold for the treatment of nausea due to migraine, it is also effective for the pain. Prochlorperazine is suitable for occasional use only. If you have previously reacted badly to prochlorperazine (aka Stemetil) or other 'old fashioned' antipsychotics, you will want to avoid Buccastem. On the other hand, the dose is relatively low and so side effects are unlikely to be severe.
Certain drugs used to treat bipolar disorder are sometimes effective in preventing migraines. Valproate can help but I know it made you feel ill. Topiramate (Topamax) can prevent migraines, a common dose is 100mg/day.
Kind regards,
Ed.
poster:ed_uk
thread:496818
URL: http://www.dr-bob.org/babble/20050510/msgs/496965.html