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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by sundancer on October 17, 2004, at 22:03:57
Hi! I really appreciate this forum and all of you who write and share. I have a question regarding the efficiency of Effexor as a preventive medication for migraines.
I do not have a history of depression or panic attackes - Effexor was prescribed to me stricktly as a preventive medication for migraines. I take Imitrex and Frova (have tried Maxalt as well) and need to find a preventive medication as my headaches are frequent and perisitent. Imitrex works fine as a rescue med but I cannot take too much as my BP goes up. Anyway,
I was prescribed Effexor XR three months ago after failing to respond to Topamax (seizure medication) and Propanolol (beta blocker) as a
preventive med. I take daily doses of Megnesium and B-2 Vitamines in addition to 500 mg Naprosyn to discourage inflamation.
After to days on 37.5 mg Effexor I was completely unable to handle my day, my job, or to drive a car! When I spoke I felt removed from myself as if hearing my own voice from inside a tin can. It totally freaked me out. But my migraines went away and for about five days I was migraine free. I felt completely "stoned" but I was migraine free. Needless to say I got off Effexor (I could not function in my job)and my doctor shot me up with massive doses of Botox instead, which hasn't helped either.
So here I am three months later and having migraines every two to three days - and obviously using too much Imitrex (Frova does not work anymore).
So I am giving Effexor another try. I take 37.5 mg of Effexor XR in the morning when I wake up. It has only been five days today days and I am experiencing bad headaches (different from migraines) when I either go to bed or when I wake up. These HA seem to be from the Effexor - they are "all over headaches" - and sometimes they go away a few hours after taking another dose (usually 2-4 hours after). I am experiencing other side effects too such as nausea, sweating, dry mouth (I am constantly thirsty!) and I am loosing weight every day. I am withdrawn, quiet, intraverted and indiffent - very unlike myself. So my question is: Will these side effect go away with time? How long can I expect it to take? The headaches are defeating the purpose of taking Effexor for me but if it goes away perhaps it's worth it? I am suppose to stay on 37.5 mg for two weeks and to not increase the dose for now. Any feedback would be great as I am inexperienced and sort of lost with this. I am loosing my life to the migraines and sometimes I feel a sense of pure despair. I don't like to be this "medicated" but if it will help decrease the migraines maybe it's worth it.....
Posted by MKB on October 18, 2004, at 0:48:28
In reply to Effexor and Migraines, posted by sundancer on October 17, 2004, at 22:03:57
What is the cause of your migraines?
Posted by sundancer on October 18, 2004, at 12:40:54
In reply to Re: Effexor and Migraines, posted by MKB on October 18, 2004, at 0:48:28
> What is the cause of your migraines?
If I only knew for sure! There seem to be a link between migraine attacks and the my hormonal cycle - period and ovulation. I can count on the headaches at these two monthly events. Then there are the foods such as chocolate and cheese as well as alchohol and sugar. I cannot drink at all. Stress (such as aggitation), lack of sleep and tension are big triggers - normal daily life in other words..... And then there is the over use of the migraine medication - Imitrex an Frova can cause rebound headaches and trap me in evil cycle of pain and medication.
Effexor has been prescribed as a med to take me off the Imitrex and Frova but I seem hyper sensitive to the med. I am pretty out of it on 37.5 mg XR and the headaches in the morning are MEAN.
I developed a pattern of migraines 8 years ago and have the same condition my grandmother suffered from.
Posted by King Vultan on October 18, 2004, at 14:18:51
In reply to Effexor and Migraines, posted by sundancer on October 17, 2004, at 22:03:57
I would suggest trying a tricyclic AD such as nortriptyline, which has utility in chronic pain situations and in preventing headaches and migraines. Because it is a tricyclic, you may notice some side effects such as dry mouth and constipation, but nortriptyline is relatively mild as far as these effects go. Having used both Effexor and nortriptyline (for depression; I also have chronic non-migraine headaches), I cannot imagine prescribing Effexor just for migraines. IMO, it has too many severe side effects, insufficient efficacy, and the possibility of suffering withdrawal symptoms if one tries to go off it after having been on it for an extended period. I would rather take my chances with a tricyclic AD, or at least try one of those first.
Todd
Posted by smith562 on October 18, 2004, at 21:40:37
In reply to Effexor and Migraines, posted by sundancer on October 17, 2004, at 22:03:57
Hey Sundancer,
Well, failing several medications (beta blockers and topamax being powerful prophylactic meds for migraine)warrants further testing, namely a MRI of the head and Xray of the cervical spine. This will rule out structural causes of your headaches. Next, many of the side effects of effexor *should* go away with time ... make sure to check your blood pressure to make sure this isnt the problem. I don't think effexor has been well studied for migraine .... there is more evidence for SSRIs and TCAs. So the alternatives would be an SSRI, TCA, depakote or verapamil. Don't forget watching this food triggers: chocolate, aged cheeses and meats, wine and beer (ie, sulfites), and citrus fruits. Hope this helped.
Smith
Posted by MKB on October 18, 2004, at 22:42:02
In reply to Re: Effexor and Migraines, posted by sundancer on October 18, 2004, at 12:40:54
I think my doctor did tell me that Effexor was good for migraines. I don't have migraines but I used to when I was younger and on birth control pills. If you are taking any kind of estrogen, maybe that is part of the problem. I think if I had migraines, I would first of all want to get at the root cause. I just wouldn't accept it as something my grandmother had.
Posted by Sad Panda on October 19, 2004, at 10:38:45
In reply to Re: Effexor and Migraines » sundancer, posted by King Vultan on October 18, 2004, at 14:18:51
> I would suggest trying a tricyclic AD such as nortriptyline, which has utility in chronic pain situations and in preventing headaches and migraines. Because it is a tricyclic, you may notice some side effects such as dry mouth and constipation, but nortriptyline is relatively mild as far as these effects go. Having used both Effexor and nortriptyline (for depression; I also have chronic non-migraine headaches), I cannot imagine prescribing Effexor just for migraines. IMO, it has too many severe side effects, insufficient efficacy, and the possibility of suffering withdrawal symptoms if one tries to go off it after having been on it for an extended period. I would rather take my chances with a tricyclic AD, or at least try one of those first.
>
> Todd
>
>I'd agree with Todd, a TCA like Nortriptyline is much more likely to provide migraine prophylaxis. If you don't have depression or anxiety, I would try meds like Cyproheptadine, Pizotifen or Methysergide first. Asprin is worth trying too.
Cheers,
Paul.
Posted by sageblue on October 19, 2004, at 11:57:51
In reply to Effexor and Migraines, posted by sundancer on October 17, 2004, at 22:03:57
Hello -- I use effexor primarily as a preventative for migraines, but it does provide positive benefits for me in the anxiety department.
I DON'T take the effexor xr version. I take regular effexor xr, 50 mgs twice a day. The neurologist I see has the attitude that if it is working, there is no need to increase the dose to the higher levels more commonly used for "mental health" problems.
I went from having migraines 7-10 times a month to about 2-4 times. (The higher number is really from when I stay up too late due to working and school at the same time.)
Maybe you could try a lower dose or try regular Effexor (not XR) and it would work for you.
Posted by sundancer on October 19, 2004, at 12:19:42
In reply to Re: Effexor and Migraines, posted by Sad Panda on October 19, 2004, at 10:38:45
Thank you evryone for your posts - i so appreciate your insight. I have been in a complaete stupor the last few days and along with my doctor we decided yesterday to cut out the Effexor for now before my brain becomes to used to the drug. My AM hadaches have not gone away so forfits the purpose of taking Effexor in the first place.
I have had a CAT and MRI of the head and spine - everything is normal. My migraines are vscular migraines and hormone changes trigges attacks. And certain foods. And alchohol. And lack of sleep (big problem with Effexor there). Anyway - I had a long serious talk with my husband last night as I need his buy in on the appraoch that has worked the best in the past - NO alchohol! He has a tendency to sabotage my efforts and order drinks for me, bring home wine and beer when I need to completely stay away from it. He likes to enjoy a coctail with me and will suggest I 'have one drink, honey,won't hurt you. Take a break". Well it does not work that way and I am ultimately responsible for staying away from triggers. So I told him I will say no - every time - from now on and he needs to be supportive and respect my health needs. There is a pattern with the same issue of me and my efforts to loose the last of the "baby-weight" - when he knows I am applying myself and dieting and running and truggling to loost the pounds he brings home doughnuts! It does not help! And he makes me feel bad when I don't participate in the indulging. He is a good mand and supportive and loving husband who adores me, but is subconsciously afraid of change.
So a clean living (I mean CLEAN) is the answer for now - no sugar, no alchohol, and lots of sleep. And help from my husband. Effexor regular strenght has been suggested in the past but I struggle with BP that goes up too much.
My goal is to have no more than 2 - 4 migraine attacks a month, I can live with that.
What I mean with having the same migraines as my grandmother just means I have inherited the genetic predisposition for migraines.Lena
Posted by sunny10 on October 19, 2004, at 13:05:03
In reply to Effexor and Migraines, posted by sundancer on October 17, 2004, at 22:03:57
Jesus- there are lots of other migraine meds to try- get off this stuff as soon as you can!
I was on only 75 mgs, dropped down to 37.5 for a few days, then none. I am on day twelve now of none.
Yesterday was the first day that I did not have 24 hrs of the brain shimmers, disorientation, and being very scared while driving and while working with only half a brain- I was afraid my supervisors would catch me drooling or something! Now they kind of come and go- which is kind of freaky- one minute I'm in control with just a migraine, the next I'm dizzy and disoriented again.Just givng you my two cents...
sunny10
Posted by sundancer on October 19, 2004, at 13:26:11
In reply to Re: Effexor and Migraines- Sundancer, posted by sunny10 on October 19, 2004, at 13:05:03
> Jesus- there are lots of other migraine meds to try- get off this stuff as soon as you can!
>
> I was on only 75 mgs, dropped down to 37.5 for a few days, then none. I am on day twelve now of none.
> Yesterday was the first day that I did not have 24 hrs of the brain shimmers, disorientation, and being very scared while driving and while working with only half a brain- I was afraid my supervisors would catch me drooling or something! Now they kind of come and go- which is kind of freaky- one minute I'm in control with just a migraine, the next I'm dizzy and disoriented again.
>
> Just givng you my two cents...
>
> sunny10Thanks sweetie. I think you are right. Lena
Posted by sageblue on October 19, 2004, at 15:15:01
In reply to Re: Effexor and Migraines, posted by sundancer on October 19, 2004, at 12:19:42
Hi --
I just wanted to say congratulations. And you should be proud of yourself for standing up for what you know is right for you.
You know, if your husband feels left out when you don't drink, maybe he'll feel just as good if you have a non-alcoholic version of the same thing with him. (A kiddie cocktail?) Or just go be by him on the couch/veranda/bar and sip something else.
Alcohol is just one of those things, like caffeine, that has a wide variety of effects on different people. Sometimes you're the one that gets the better effects, sometimes you're not.
As for the weight loss thing, I've noticed the same trend around my place. My partner, I think, is scared of being forced to change when it's me who needs to lose the weight. Suddenly cookies are coming home. !!!! But my latest 'diet,' over a week now, has been successful due to my incredible determination to succeed. :)
Good luck, woman. :D
Posted by jboud24 on October 20, 2004, at 15:10:00
In reply to Re: Effexor and Migraines, posted by sundancer on October 18, 2004, at 12:40:54
Posted by Starlight on October 21, 2004, at 13:10:53
In reply to Effexor and Migraines, posted by sundancer on October 17, 2004, at 22:03:57
It seems like 37.5 is an awful low dose to be causing such extreme side effects. I have only recently started getting migraines and am on 75 mgs of Effexor, but I think that my hormone fluctuation from getting pregnant is what caused the onset of the migraines, which I've never had before. I wake with them and it's horrible. I've never heard of treating HA with Effexor though, I have frequently heard of treating them with anti-convulsants. Good luck and I'm sorry you have to deal with migraines.
starlight
Posted by sundancer on October 21, 2004, at 14:30:10
In reply to Re: Effexor and Migraines, posted by Starlight on October 21, 2004, at 13:10:53
> It seems like 37.5 is an awful low dose to be causing such extreme side effects. I have only recently started getting migraines and am on 75 mgs of Effexor, but I think that my hormone fluctuation from getting pregnant is what caused the onset of the migraines, which I've never had before. I wake with them and it's horrible. I've never heard of treating HA with Effexor though, I have frequently heard of treating them with anti-convulsants. Good luck and I'm sorry you have to deal with migraines.
> starlightI know!!! I seem to be hyper sensitive to drugs. I am on day three off Effexor today (I was only "on" for 6 days) and sooooo dizzy. Yesterday I was crazy nauseaus too. My new approach is to completely stay away from refined sugar and ANY alchohol - seem to be working fine. I was put on 40mg Inderal (propanolol) and as long as my heart rate does not drop too low I am staying on it. 40mg of Inderal is "nothing" but for me it is almost too much. I was taken off the beta blocker in July when my heart rate dropped to 30; my primary care doc almost was inclined to send me to the ER when the EKG came back with 29 and 30 beats per minute.
My neurologist doc is a pretty compasionate man -he himself has been propanolol 80 mg for many, many years to treat his own migraines. He encourages me to try it again as the Effexor was not something I tolerated nor "needed" per se. I am not deperessed and it changed my personality way too much.
I believe my migraines condition will greatly improve if I stay away from alchhol. I love the long dinners with good wine, sushi with beer and sake - it's like saying goodbye to an old friend. And hopefully the Inderal will augment this approach in a positive way. I also had a spike in the migraine attacks after my daughter was born but tapered of 4 months post partum.Lena
Posted by Starlight on October 22, 2004, at 11:00:22
In reply to Re: Effexor and Migraines - Starlight, posted by sundancer on October 21, 2004, at 14:30:10
Did you do any online research regarding migraines and Effexor. That just seems so strange to me. But then, in looking back, as I was ramping up on the Effexor, I did have some strange side effects. Mainly that I had a hard time sleeping and did feel some nausea, but that passed pretty quickly. Any anti-convulsant in the mix?
starlight
Posted by MKB on October 23, 2004, at 0:11:04
In reply to Re: Effexor and Migraines, posted by MKB on October 18, 2004, at 22:42:02
I believe I may have caused some confusion here. I first said my doctor said Effexor was used to treat migraines. As I've thought more about it, I think she was talking about Depakote, not Effexor. (We discussed both medications on my last visit.) I'm sorry if I gave wrong information.
Posted by sundancer on October 23, 2004, at 18:11:57
In reply to Re: Effexor and Migraines - Starlight, posted by Starlight on October 22, 2004, at 11:00:22
> Did you do any online research regarding migraines and Effexor. That just seems so strange to me. But then, in looking back, as I was ramping up on the Effexor, I did have some strange side effects. Mainly that I had a hard time sleeping and did feel some nausea, but that passed pretty quickly. Any anti-convulsant in the mix?
> starlight
I do NO research online - I found this site only a few days ago and has been a huge help! Well, I have used the following site for info but it is only superficilal information for someone like me: http://www.upstate.edu/neurology/haas/hpmirx.htm#tranquilizers
Yes - I was on Topamax for about four months and it did not help much (it's considered an anti-convulsant right?). Later I found out I was on too small of a dose, but I was still left with a seriously metallic tast in my mouth. I had some very serious hallucianting dreams on Topamax too - in the interim between sleep and the awake state I saw terrifying tings and I knew they were hallucinations! It freaked me out. With time it subsided but the nurse did not increase my dose. Probably should have as I could have gotten more relief back then.
Now things work pretty good - no alchohol and 40 mg Inderal eveery other day as my heartrate can drop too much. No migraines in 5 days now....thanks for all the feedback this really really helps me and I don't feel so alone with my condition and I know that others who struggle like me. Finding the right meds is can be so
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