Read on some places that MAV (especially those with WM changes on MRI) maybe shouldnt be treated with Triptans?
What abortafactents are safe then?
They say that triptans don’t work for MAV, as they are not a preventative. THey also don’t get along well with a lot of preventatives that have serotonin enhancing (like the antidepressants). I think for abortive meds, tylenol and Ibuprofen are the ones that are supposed to be okay.
Kelley
who is “they” Kelly? I have read that there are no randomized studies, only open label ones and in those they worked OK
“They” are the people who write the articles that I’ve read, and the doctors that are mentioned on this board as well as throughout different internet sites. Scott is the pro at doing the actual links to the science based reports. I will ask him to provide the links if he can.
Kelley
Dougiied,
I’m living proof that triptans are not good for MAV people. A triptan is what sent me to the ER once. I’ve also read the same things Kelley has about triptans and migraine variants. I’ve read that people with basilar migraine could actually have a stroke if they took a triptan. And there’s a lot of pain with basilar migraine so you’d think a triptan would be the way to go for basilar migraine. Apparently not so. It can be very dangerous.
Greg
Well I have to say this is very interesting because I’m living proof that triptans are very safe and effective for migraine. I’ve used Immitrex for 10+ years and while taking SSRIs with no issues and both pharmacists and neurologists have assured me the risk of serotonin syndrome is incredibly small and is overblown.
I’m very well aware of the symptoms of serotonin syndrome and know it’s very, very rare, and feel that is good enough to continue taking a triptan when I have a migraine headache that Tyelnol won’t touch.
Hey Anne,
I think that triptans are not for MAV per se, but they do work for migraine headaches…even if one is on a preventative. I haven’t seen anyone on here do well on triptans for a preventative…they are** abortive** meds.
Kelley
Anne,
I most likely had a bad reaction to midrin. Don’t know if imitrex or another different triptan would also give me a bad reaction. But I’m definately too scared to try and find out. I hardly get headaches and when I do they’re not even bad enough to take an advil over, so abortive meds aren’t even in my mind of ever trying anyway. I don’t see the reason taking them if you don’t have the head pain.
I’ve heard that they constrict blood vessels to relieve head pain in the swollen blood vessels around the head. There are theory’s that migraine aura’s and other symptoms are the result of inadequate blood flow in certain area’s in the brain, and if you take a triptan, the blood flow is even more constricted and it’s possible that the blood vessels could constrict too much and maybe cause a stroke. I’m sure a stroke from a triptan is rare though, just not recommended with migraine variants.
I know there are plenty of migrainers out there that have an aura and then throbbing head pain who take triptans and seem to be fine on them so who knows.
I don’t know what happened in my case. I know I didn’t have a stoke, but I had some seriously bad dizziness within a few hours after I took midrin.
Greg
yes, my question was about their use as abortive meds. So in our study of two people we have one who has used them to great effect and one who had an adverse effect.
My neuro told me they work well for classic migraine headaches but not for someone like me who has silent migraine (aura, dizziness, tinnitus, etc) but no headache. He said the chance of seratonin syndrome is very low.
Dougiedd,
I don’t know if it’s a good idea to use the forum here to put together a triptan trial to find out if they are safe or not. It obviously wouldn’t be a controlled study anyway so the results you’d get would be a little skewed. But this forum is great for information. There are a lot of people here that have helped me a lot along my path with MAV. If it weren’t for this forum, I wouldn’t know half of what I know now. This forum is truly wonderful and so is everyone here. You couldn’t ask for a more knowledgeable and caring group of people. This place is the best!
But as far as the safety of triptan use for you, you might want to double check it with your GP just in case. But at least you know now (from the forum here), that there is at least 1 person who had a disasterous reaction from a triptan and 1 person who has had no problem at all with them. So if I were you, I’d take the info here and present it to my GP and see what they think is best. That’s the only thing you can do. Meds can be scary, but I’d have to think that there are more success stories than horror stories with them. I guess I was just one of the unlucky ones. But that’s life isn’t it.
Good luck!
Greg
Kelly, thanks for clarifying–I was thinking I was reading here an overall blanket statement that triptans aren’t safe and was a bit shocked by that. Yes, prevention versus abortive means are two completely different things.
It also seems as if we are talking about triptan use for two cdifferent types of migraine: those with pain and those without. I also don’t see the point in triptan/sumatriptan use if there is no headache pain. I have always been a classic migraineur with pain but no aura. Then the MAV hit but I still get migraine headaches.
thanks greg: i hope everyone here knows the usual disclaimers about not using this information to replace medical advice.
my quip about the study was tongue in cheek
— Begin quote from “beatles909”
Dougiedd,
I don’t know if it’s a good idea to use the forum here to put together a triptan trial to find out if they are safe or not. It obviously wouldn’t be a controlled study anyway so the results you’d get would be a little skewed. But this forum is great for information. There are a lot of people here that have helped me a lot along my path with MAV. If it weren’t for this forum, I wouldn’t know half of what I know now. This forum is truly wonderful and so is everyone here. You couldn’t ask for a more knowledgeable and caring group of people. This place is the best!
But as far as the safety of triptan use for you, you might want to double check it with your GP just in case. But at least you know now (from the forum here), that there is at least 1 person who had a disasterous reaction from a triptan and 1 person who has had no problem at all with them. So if I were you, I’d take the info here and present it to my GP and see what they think is best. That’s the only thing you can do. Meds can be scary, but I’d have to think that there are more success stories than horror stories with them. I guess I was just one of the unlucky ones. But that’s life isn’t it.
Good luck!
Greg
— End quote
in general i think they are very safe, ive had naramig and probably some others (i dont know as i use to get injections and wasnt in any condition to ask the dr so could have been anything ) I recently found out that i shouldnt have vasco contrictors(triptans etc) due to doggy blood vessels in my brain but in the past ive had plently and it didnt do any damage. For mega migraine they are fair to good… otcs do nothing… its like eating lollies.( 25mg stemitels arent 2 bad 4 mega migraine but not long term use)
so in general yes safe, but get an mri to check, major migraine suffers should have this done anyway i think and make sure about other drug interactions. For vertigo itself they dont do anything. You only get four in a pack here so theres a limit per month. If i get a mega migraine, havent had one in yrs just headaches but have chronic vertigo :?: ill call up the big boys for pain relief at the quaks/hospital from now on
Dougledd –
Kelley knows her stuff on this as she has seen the articles I’ve posted on various migraine-realted topics over the years. She knows meds and their actions better than I do. I have never read anything in the literature or heard anything from any specialist that suggests triptans are any good for chronic migraine. However, they are effective for some people who experience non-chronic migraine when they are taken at the correct time (i.e. triptans should NOT be taken during an aura). Note, that like painkillers, triptans may cause rebound and could also send a person experiencing the odd migraine headache into a chronic state.
Chris Silver says this about triptans:
— Begin quote from ____
Some patients will be prescribed triptan drugs which specifically work to turn off migraine. These need to be taken early, at the onset of a throbbing headache, if necessary using the subcutaneous injector device (Imigran 6 mg)or nasal spray (e.g. Zomig 5 mg). Triptans should never be taken during an aura, only at the onset of a throbbing headache. In addition, they are best avoided if patients have experienced attacks of aura in the past that have lasted more than an hour.
If however patients experience bits of milder headache between attacks they should be cautious taking such “acute attack medication”, as painkillers and triptans may perpetuate attacks and lead to rebound headaches and chronicity of their condition. Caffeine may also perpetuate migraines into a chronic daily headache.
Alarm bells for medication or caffeine overuse ring if patients start developing minor headaches between the severe ones or if they notice that the original medications are no longer working and that they need to go to stronger painkillers. If that happens, it is advisable to follow the advice given below under the heading of chronic migraine. As a general rule, I usually suggest general avoidance of acute attack medications other than domperidone for nausea if there are typically less than 27-28 “brilliantly crystal clear” headache free days per month.
— End quote
There’s more on this from Steve Rauch but it’s late. I’ll find it tomoorow.
Best … Scott 8)
HI Scott,
Thanks for posting. I feel badly that I couldn’t name names, but I don’t keep the literature anyplace but in my head. I realize some people want to have some proof and not just listen to a random person on a forum, since who knows who we’re really talking to! Those on this site for a long time come to realize just how much knowledge there is here, and those of us who are permanent fixtures, don’t really question the people who have been marinating in this info for years now… lol
Hugs,
Kelley
It was a long time ago that I tried them but I seem to recall there was something on the leaflet saying not to be taken by people with basilar migraine. I also read other stuff that said not to be taken if you have basilar migraine. This was the first diagnosis I had so I was wary. They were rubbish for me anyway. Even with a major painful migraine, they did very little but make my throat close up (very frightening), I couldnt even swallow tea. I believe they are too general and constrict where they shouldnt. Also, the pain would go away somewhat then come back 3 or 4 hours later and I would have to resort to painkillers anyway. Having said that, I have a friend who has had painful migraines (not MAV) all her life and they work well for her.
Christine