I occasionally take Vicodan (sometimes with a low dose of valium) when I have a killer migraine that won’t quit. The only problem is, it isn’t strong enough. My reaction to most painkillers is very minimal, and always has been. Most people I know fly when they are on Vicodan - unless I take a double does, I don’t even notice any difference.
Just this week I had to go to the ER for Demerol, and this migraine had gotten so bad by then that even that didn’t totally get rid of it.
My doctor is a little hestitant to prescribe pain-killers for me. I have been seeing him for years for the migraines, so he knows I don’t have a drug habit. But he tells me that there is nothing stronger he can prescribe, and I’m not sure I’ve believe him. I just want to be able to manage the pain.
So are there any prescription painkillers that are stronger than Vicodan?
And yes, I have tried the meds that are specifically for migraines (Imitrix, Zomig, etc). They work only about 50% of the time, and only if it’s a minor-to-moderate migraine. I have also tried Darvocet, which doesn’t do much, either.
IANAD, but I do have some familiarity with analgesics.
There are quite a few analgesics that are stronger than Vicodin. And there are others in the same class that may work better for you than Vicodin does. Each person reacts differently to different drugs.
I’m not endorsing any of these sites, just providing them as research options.
Sorry, I don’t have time to hunt up more info for you right now. But I’m sure that if you do a bit of Web researching, you could come up with some alternatives to suggest to your doctor.
Doctors have for years been reluctant to prescribe opiate analgesics for fear that their patients will become addicted. However, I remember reading recently that doctors are now being advised to treat pain and worry about the addiction problem later. That’s something else you can probably hunt up on the Web.
I’ve always found my own doctor to be very open to suggestions when I’ve presented her with the research I’ve done and the options I’d like to try.
Re: acupuncture - I’ve tried it, and it didn’t seem to help. Initially I thought it did - for a while I was doing ok. But I started acupuncture about two or three months ago, and since then then have had two very long, very painful migraine attacks. One lasted 6 days, and this one, which sent me to the ER, is on its 4th day. But the double dose of the V/V cocktail I took seems to be kicking in finally and getting rid of the last of it. I’m hoping I don’t get a rebound tomorrow.
I am also going to consult with a new neurologist at Northwestern.
I too am a migraine sufferer. My neurologist found that 50 mg of zoloft is effective at preventing/reducing the severity. I take a pill every night. It took about 3 months for any effects to be noticed and a year before the full effect. But after 6 years, it has been a migraine. I went from daily to one week out of six.
And exercise helps ALOT too.
Hydrocodone (in Vicodin) is somewhat less effective than oxycodone (in Perocet and Percodan).
As an aside, narcotics like those above are often not terribly effective in “intractable” and/or severe migraine. In hospital emergency departments, drugs like chlorpromazine are often employed with success (see this recent review for example).
howardsims, I’m also on 50 mg Zoloft as well as 240 mg Verapamil daily as a preventative. It’s not working, and I’m going to talk to my neuro about trying something else. I was up to 480 mg of Verapamil a day, which worked great at preventing the migraines, but my blood pressure got so low (90/60) that I almost passed out. In 8 years of being on preventatives, I’ve never found one that’s even close to 100% effective with acceptable side effects. Typically the preventative will work for a while, then we have to increase the dose, which typically leads to bad side effects.
I hope the Zoloft continues to keep your migraines under control.
I do need to get back to lifting weights at the health club - I have been so busy at work the last few weeks, and now too sick to go.
Actually, Vicodin sucks as a “pain releiver”- the Tylenol does most of the actual pain relief. The codeine-stuff relaxs you, makes you high, and allows you to sleep. For migraines- try Exedrin, or other aspirin/tylenolclone/ caffiene pills. That is, during the daytime, if you don’t want to go to sleep. At nite, aspirin, or motrin-clone, (up to 800mg, if your stomach can stand it, depending on your body size)plus a couple glasses of wine, etc.* will do the trick. However, certain red wines set off migraines in some folks. I am not a Medical Professional
do not take Tylenol or clones of it, and drink at the same time. Or if you do drink, more than a little- lay off the Tylenol.
I agree that Vicodin sucks as a painkiller. Some people really like it tho…it just makes me sick to my stomach and makes me feel dizzy. What an awful feeling! I hate that stuff. Same with the Darvocet. I take a schedule II drug as part of pain management treatment. Many of the patients at the clinic are receiving meds for treatment of migraines.(My pain is not from migraines) I can’t see the reasoning behind your doctor saying there was nothing stronger? You just have to find the right drug that works for you. You should be able to prevent the onset of the migraine and esp. stop it from reaching a pain level that requires a trip to the ER. While you do have to jump thru some hoops to get into pain management, in your case it looks like it might be needed. The migraine sufferers which I have met are each using a different drug. I know that I would not be able to function at all without schedule II drugs. You really shouldn’t have to suffer with pain…luckily the medical community has finally started to understand this. Tell your doctor you would like to be referred to a pain mgt. clinic. There are few and far between and always very busy. In my state there are only two clinics and they prescribe all the meds for many hundreds of patients. But with the clinic setting and a doctor who specialises in only pain control, it takes the heat off a doctor who is afraid to prescribe schedule II drugs. The regulations have made most doctors unwilling to help with pain control…this way they can still try to treat the origin of the problem…while you can live without pain. Good Luck!
Origato, believe me, if I could get pharmacutical grade heroin legally, I would. And I am so glad the government has my best interests at heart. :rolleyes: <we need a hurling smiley>
Daniel, I appreciate the suggestions, but Tylenol and other OTC remedies like Excedrin don’t do anything for my most benign migraines, much less the moderate to severe ones. I have tried cafergot (ergot and caffeine), which sort of worked, but again, the side effects were so bad that it wasn’t worth it - I had to take so much to relieve a moderate migraine that I had severe shakes from the caffeine. And interestingly enough, I don’t get a high at all from the Vicodan/Valium cocktail I was taking yesterday. If I can get some pain relief, that’s generally the only effect. I was talking to a friend on the phone yesterday night about an hour after I’d taken two of each, and she found it hard to believe I’d taken anything, because I sounded perfectly normal and lucid.
Sapphire Bullet, for some people, caffeine helps relieve migraines; for other people, it contributes to them. Nobody really understands what causes them.
midnite, when I go to my new neuro at Northwestern, I will talk to him/her about a pain management referral. Thanks for the suggestion.
handy, for a mild migraine, usually sleep gets rid of it. Lately I have been going to bed with a migraine, and often waking up feeling worse. I certainly wish the answer were as simple as you propose, but it isn’t.
porcupine, I have heard that biofeedback can work wonders for some migrane sufferers. The basic theory as I remember it is as follows:
The migrane is cause by some problem with adrenaline. As levels slowly build, blod vessels in the head start to constrict. Very slowly (over the course of a few hours) they get tighter and tighter. At some point, they reach a point of no return, and the body automatically starts to open the vessels up.
This is the beginning of the migrane proper. Vasodilation continues until the blod vessels are open like floodgates. The muscles in the arterial walls go completely slack, and the brain becomes engorged. Pressure in certain parts of the brain skyrockets, compressing tissues and causing such symptoms as visual auras, nausea, etc. The pain itself is in the blood vessles and the meninges.
Biofeedback works by learning to control the third (maybe- memory is fuzzy here) vagus nerve, which mediates the adrenal glands. As soon as you feel the original constriction start up, you can use your biofeedback training to halt the overproduction of adrenaline, and short circuit the whole process.
Well, the long-held view that the migraine aura is due to vasoconstriction (constriction of the arteries in the brain) with subsequent lack of blood flow to certain areas of the brain causing the aura (eg. flashing lights) is probably “too simplistic”. This review from the Lancet is a good overview of migraine in general. This one, from the British Medical Journal, focuses on treatment. Both are written for docs but I am sure that you’ll find them informative.