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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by cmcdougall on December 27, 2001, at 10:48:49
I have suffered from migraines and chronic daily headaches starting about 6 years ago, and getting much worse over the past 18 months. During this time I have taken trazodone (300mg/day - couldn't increase dose any further, too sedating), tried wellbutrin (didn't like it - made me spacey), then serzone (pooped out after 2 years), then effexor xr - I have also taken ritalin for the past 8 years.
When I started the effexor xr, I read that it is sometimes prescribed to treat chronic headaches and migraine. This was good news to me as nothing I've tried does any good. I can't use any of the new triptans - they make my migraines WORSE. I don't like to take analgesics because of the risk of rebound headaches, they don't work very well, and I worry about taking so many drugs already. In the past I have tried chiropractic, accupuncture, chinese herbs, homeopathic, and anything else that I could find.
Well, the effexor pooped-out pretty fast for me but unfortunately I really didn't notice until I was in a severe depression (I've NEVER felt so hopeless in my life). The bad thing about poop-out is how it sneaks up on me. I should have seen the signs, ie. 3AM wakeup, no motivation, wanting to nap all day, not taking care of business or going to work and then lying about it, etc. My dear husband kept telling me I was acting funny and asking what was wrong, but I just snapped at him and thought he was being hypercritical. Typical, huh? ;-)
On the way to a med check-up in October, I was thinking about what I would talk to my pdoc about. All of a sudden, everything fell into place and I realized what had been going on for the past YEAR. AD poop-out again. Now thats really depressing. I had to get off effexor and at the same time, start a new AD - celexa.
About two weeks into the titration off effexor, I had an appt w/ a new neurologist about the headaches which had gotten MUCH worse over the past year and especially the past two weeks. I really wasn't connecting the headaches w/ AD withdrawal - I never had severe problems changing drugs before. Anyway, the neuro prescribed neurontin - 300mg to start and titrate up to 2400mg per day over a 36 day period. I told her that I was in the process of changing ADs, but she assured me that the neurontin would make no difference w/ the action of the ADs and would get rid of the daily headaches once I got to a proper level.
I took the neurontin for two days and ended up in the psych ward after teetering on the edge of psychosis. Never in my whole life have I experienced such a horrible feeling. Panic, non-stop crying, suicidal threats, no grasp on reality, and on and on. Of course, I blamed the neurontin but my pdoc says it probably wasn't. He thinks I "just" had an extremely rare, bad effexor withdrawal syndrome. After reading this board since then, I think my experience isn't really so "rare".
Now the interesting thing is that looking back, I realize my headaches and painful neck and shoulder tension were WORSE on the effexor than ever before. Isn't this stuff supposed to make those better? Now that I have been completely off the effexor since Nov my headaches are much, much better. I get a migraine only once every week or two, and I don't wake up w/ a tension headache every day. I sometimes get a headache in the afternoon, but I can deal w/ it. That might seem like a lot of headaches still, but after having 3-4 migraines a week this a big improvement. I am going to continue w/ the process of filing for SSDI though. Even 1 migraine a week makes working a regular job impossible.
I am now taking a cocktail consisting of celexa 40mg/day, desipramine 50mg/day, adderall 20mg/3xday, trazodone 50-100mg/night. I also take an occasional xanax if needed for anxiety.
My questions for you learned friends are:
*Could that small dose of neurontin, along with the other stuff going on trigger psychosis? Or is my pdoc probably right about the effexor withdrawal...
*Have you ever heard of Effexor making migraine or FMS worse?
*Has anyone had luck using Neurontin to prevent migraines?
*If you suffer headaches, what is your drug of choice?
*What ADs gave you headaches or made them better?
*And last but not least, what do you think of my current drug cocktail, and how should it relate to my headaches? 4 weeks into it and I really like it. Feel better now than in a looong time. Just wish I could get rid of the migraines and headaches for good....Sorry this is so long. Thanks in advance for your input.
Carly
Posted by IsoM on December 27, 2001, at 11:56:57
In reply to Migraine , chronic headache w/ Effexor or others?, posted by cmcdougall on December 27, 2001, at 10:48:49
Carly, I can only answer a couple of your questions.
I used to have migraines/headaches as often as you did. Hard sometimes to tell what was the what as sometimes I had auras & sometimes didn't, but they all hurt like hell anyway & often I would have a very sick stomach with it.
Have you ever tried beta-blockers? I honestly have no idea how they may, or may not, interact with your other meds. Beta-blockers didn't work for me (instead brought on a massive asthma attack that put me in the hospital - but I had no idea I was even slightly asthmatic), but when they do work, they're supposed to be wonderful!
All the standard migraine meds didn't do anything for me except the odd one of putting me to sleep immediately. I was far too frightened to try some of the very powerful drugs the neurologist suggested like Depakene (valproic acid) & Neurontin (gabapentin) though in retrospect they might have helped as I seem to have indications of temporal lobe epilepsy too. ADs didn't help my headaches, but they didn't seem to make them worse either. I'd just about given up & accepted them as my part of life. But a few years ago, I started a job that required me to be constantly on the move & to work fairly hard physically. Still within my physical capabilities but I'd be pretty sweaty from the whole thing & always need a shower when I came home. Lo & behold! my headaches disappeared.
The first week of working with headaches was hard, but they soon faded after that week. I do have bona fide migraines occasionally, but will generally retire to bed with codeine & Gravol for those. Work is pretty good as the manager likes me & has had migraines himself so I can always go home but have only needed to do so three times in the last 1 1/2 years.
You mentione d you have "headaches and painful neck and shoulder tension", just like I did. Old injuries have made me very susceptible to muscle tension in that area & for me, sustained physical work has been the best cure I've ever had. All other avenues (like you, chiropractic, accupuncture, Chinese herbs, massage therapy) failed to help. I think physically working my muscles takes the tension from them so they can properly relax. I never realised how much they were tied in with my headaches, even the one-sided throbbing headaches.
****************************************************************************************************
> I have suffered from migraines and chronic daily headaches starting about 6 years ago, and getting much worse over the past 18 months. During this time I have taken trazodone (300mg/day - couldn't increase dose any further, too sedating), tried wellbutrin (didn't like it - made me spacey), then serzone (pooped out after 2 years), then effexor xr - I have also taken ritalin for the past 8 years.
>
> When I started the effexor xr, I read that it is sometimes prescribed to treat chronic headaches and migraine. This was good news to me as nothing I've tried does any good. I can't use any of the new triptans - they make my migraines WORSE. I don't like to take analgesics because of the risk of rebound headaches, they don't work very well, and I worry about taking so many drugs already. In the past I have tried chiropractic, accupuncture, chinese herbs, homeopathic, and anything else that I could find.
>
> Well, the effexor pooped-out pretty fast for me but unfortunately I really didn't notice until I was in a severe depression (I've NEVER felt so hopeless in my life). The bad thing about poop-out is how it sneaks up on me. I should have seen the signs, ie. 3AM wakeup, no motivation, wanting to nap all day, not taking care of business or going to work and then lying about it, etc. My dear husband kept telling me I was acting funny and asking what was wrong, but I just snapped at him and thought he was being hypercritical. Typical, huh? ;-)
>
> On the way to a med check-up in October, I was thinking about what I would talk to my pdoc about. All of a sudden, everything fell into place and I realized what had been going on for the past YEAR. AD poop-out again. Now thats really depressing. I had to get off effexor and at the same time, start a new AD - celexa.
>
> About two weeks into the titration off effexor, I had an appt w/ a new neurologist about the headaches which had gotten MUCH worse over the past year and especially the past two weeks. I really wasn't connecting the headaches w/ AD withdrawal - I never had severe problems changing drugs before. Anyway, the neuro prescribed neurontin - 300mg to start and titrate up to 2400mg per day over a 36 day period. I told her that I was in the process of changing ADs, but she assured me that the neurontin would make no difference w/ the action of the ADs and would get rid of the daily headaches once I got to a proper level.
>
> I took the neurontin for two days and ended up in the psych ward after teetering on the edge of psychosis. Never in my whole life have I experienced such a horrible feeling. Panic, non-stop crying, suicidal threats, no grasp on reality, and on and on. Of course, I blamed the neurontin but my pdoc says it probably wasn't. He thinks I "just" had an extremely rare, bad effexor withdrawal syndrome. After reading this board since then, I think my experience isn't really so "rare".
>
> Now the interesting thing is that looking back, I realize my headaches and painful neck and shoulder tension were WORSE on the effexor than ever before. Isn't this stuff supposed to make those better? Now that I have been completely off the effexor since Nov my headaches are much, much better. I get a migraine only once every week or two, and I don't wake up w/ a tension headache every day. I sometimes get a headache in the afternoon, but I can deal w/ it. That might seem like a lot of headaches still, but after having 3-4 migraines a week this a big improvement. I am going to continue w/ the process of filing for SSDI though. Even 1 migraine a week makes working a regular job impossible.
>
> I am now taking a cocktail consisting of celexa 40mg/day, desipramine 50mg/day, adderall 20mg/3xday, trazodone 50-100mg/night. I also take an occasional xanax if needed for anxiety.
>
> My questions for you learned friends are:
> *Could that small dose of neurontin, along with the other stuff going on trigger psychosis? Or is my pdoc probably right about the effexor withdrawal...
> *Have you ever heard of Effexor making migraine or FMS worse?
> *Has anyone had luck using Neurontin to prevent migraines?
> *If you suffer headaches, what is your drug of choice?
> *What ADs gave you headaches or made them better?
> *And last but not least, what do you think of my current drug cocktail, and how should it relate to my headaches? 4 weeks into it and I really like it. Feel better now than in a looong time. Just wish I could get rid of the migraines and headaches for good....
>
> Sorry this is so long. Thanks in advance for your input.
>
> Carly
Posted by bob on December 27, 2001, at 12:44:10
In reply to Migraine , chronic headache w/ Effexor or others?, posted by cmcdougall on December 27, 2001, at 10:48:49
Hey Carly... I just wanted to make a comment about the Neurontin: I wouldn't doubt that you had a bad reaction to it. I had a similar nasty reaction to Topomax. It was the worst experience of my life. None of the doctors I've told it to seem to recognize that the drug could have had the effect I said it had.
Posted by Anna Laura on December 27, 2001, at 23:44:43
In reply to Migraine , chronic headache w/ Effexor or others?, posted by cmcdougall on December 27, 2001, at 10:48:49
My questions for you learned friends are:
*Could that small dose of neurontin, along with the other stuff going on trigger psychosis? Or is my pdoc probably right about the effexor withdrawal...
*Have you ever heard of Effexor making migraine or FMS worse?
*Has anyone had luck using Neurontin to prevent migraines?
*If you suffer headaches, what is your drug of choice?
*What ADs gave you headaches or made them better?
*And last but not least, what do you think of my current drug cocktail, and how should it relate to my headaches? 4 weeks into it and I really like it. Feel better now than in a looong time. Just wish I could get rid of the migraines and headaches for good....Sorry this is so long. Thanks in advance for your input.
Carly
Hi Carly
I wanted to answer your question pertaining Neurontin triggering psychosis: i don't know about that specific drug but what i do know is that some people can definetely have an odd reaction to meds.
A friend of mine told me her brother had a severe psychotic reaction with a regular benzo at low doses. He suffered from panic attacks and took xanax to relieve his anxiety. He started behaving in a odd manner , he went like manic and he was about to stab his sister at one point!
He eventually realized that he was experiencing a kind of strange side effect due to the drug and he quit it. He came back to normal within a few days: he switched to omeopathy at the end.
As far as i am concerned, benzos and antypsychotics make my depression worse,as well as hormones.
Back in 1997 i was given corticosteroids for something resembling CFS syndrome and got psychotic within a few days. Never felt so horrible in my whole life.
A friend of mine was given cortisone for mono years ago. He began to develop paranoid ideation: he thought his mother and his sister were conspiring against him.
As you can see, everyone is different, having a unique neurophysiology and showing different reactions to the same class of med as a consequence.
As far as headaches are concerned, i'm experiencing pretty bad ones : i'm going back to effexor at the moment (i've been tapering it and went back on it within a few weeks, too long to tell you why).
What kind of migraine are you suffering from?
Could they be tension haedaches? If it's so, they may be anxiety-related and they got worse as you withdrew from effexor.
Sure antidepressant drugs may work for migraines but may be effexor wasn't the right med for you. May be it wasn't working at all.I found an article on migraines treatment on this site may be you'd like to take a look at it:
http://www.svhs.org/news/hrheadachesantidepress.htm
Treating MigrainesSeveral different medications are used to treat migraines. But what works for one patient may not work for another. So doctors must often rely on a trial-and-error approach until they find the right medication and correct dosage.
Years ago, doctors noticed people getting antidepressants had fewer headaches. So some physicians started prescribing the drugs for migraine. The drugs are ideal for patients who suffer migraines and emotional problems related to the headaches (such as depression).
Tricyclic antidepressants (such as ELAVIL® and PAMELOR®) work very well for migraine symptoms. But these drugs can have unpleasant side effects in some people, causing drowsiness, dry mouth, weight gain, constipation, heart rhythm abnormalities, and confusion. A newer class of antidepressants, SSRIs (selective serotonin reuptake inhibitors, such as PROZAC® and ZOLOFT®), have fewer side effects but are slightly less effective for migraine pain.
"....Doctors say the antidepressants may also be useful for some people with other types of headaches. Other types of medications used for migraine include beta-blockers, calcium channel blockers, and certain anti-seizure medications. Some migraine sufferers are helped with biofeedback or relaxation techniques. Avoidance of known migraine triggers is also an important part of therapy."
Saint Vincent Pain Services
Posted by cmcdougall on December 28, 2001, at 9:40:21
In reply to Re: Migraine , chronic headache w/ Effexor or oth, posted by Anna Laura on December 27, 2001, at 23:44:43
Dear Anna Laura,
Thanks for the info...
> What kind of migraine are you suffering from?
I get all kinds of headaches - classic migraine, migraine w/ aura, basilar migraine, even weird migraines where I have no headache, but all the other symptoms ie. nausea, confusion, vertigo, and visual aura.
> Could they be tension haedaches? If it's so, they may be anxiety-related and they got worse as you withdrew from effexor.Oh I definately get tension headaches too. They often go on to trigger a full-blown migraine. Looking back, I do believe now that effexor withdrawal made my headaches worse. And because I am experiencing dramatically reduced migraine since I've been off effexor, I think it was contributing to them the whole 18 months I took it.
Oh well.... I just have to chalk it up to another disappointing med trial. Hopefully my new regimen will work for a couple of years.
Thanks to you and all else who responded.
Carly
This is the end of the thread.
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