constant headaches

Hi, I’m a new member, so I’ll just introduce myself and my problem with headaches, and I hope to hear suggestions from you. I’m 26. I have daily headaches for 7 years. I don’t know if they are migraines since I don’t know how much painful a migraine headache is, but mine is not one-sided, it’s all across the head with a huge weight/pressure feeling (and no vomiting). When the headaches started it was like 2-3 a week, but then it got worse and worse, and within a year it became constant. Since then, I have constant headaches. It doesn’t go. Strong or weak, it’s always there. When I wake up in the morning, it’s there. Usually I have no relief during the day, sometimes I do (with the help of drugs) but then in the morning the headache is again present. So there goes my first question: Everyone is saying that you should find the trigger, but how can I find the trigger when it all starts when I open my eyes to the day? How can it have a trigger when it’s constant and when it has no starting point beceause of the simple fact that it doesn’t end.

The only medication which helped me was a mixture of sibelium and cipram. Sibelium is a long term medication for migraine patients (like topamax). And Cipram is an anti-depresant. Actually the doctor gave me Cipram because Sibelium had the side effect of depression! Only that I didn’t know that at the time. After I found about the depressive side effect of Sibelium, I asked him and then he told me the scary truth. Anyhow those drugs really worked. They reduced the headaches to 2-3 a week (and they were very weak). But after 2,5 years I was very anxious about the side effects of Sibelium. It made me really depressive and I was sleeping all the time. I was sleeping 12 hours a day and it was still not enough. It was affecting my life, nearly more than headaches! So I quit the medication. But then headaches came back. Constant. Daily. I tired acupunctur and massage. But it didn’t work.

Now, I’m trying Topamax, 25 mg a day. It’s a week now, and no progress. I told my doctor that the headache is there now for 40 days constantly, and there is not a single day without it. And he told me that if it’s constant it may be caused by depression so I should also take an anti-depresant (Cipram) with Topamax. I’m really confused here, and need to ask questions, which I can’t ask my doctor:

1- I was taking Sibelium and it reduced the headaches. But it also made depression. So I stopped it. And I’m not depressed anymore. But my headaches came back. And now, my doctor says that my headaches can be caused by depression. How can this be? Doesn’t Sibelium make depression and also make my headaches go? Isn’t there a contradiction here? I’m really confused.

2- How can I know that my headaches are rebound headaches or not? I didn’t know anything about those, and I was taking a lot of avmigran/zomig/apranax/cataflam… But how to differentiate a rebound headache when your headache is constant?

3- Has anyone tried psychological therapy? Is it possible to reduce the headaches without medication?  

 

Thanks a lot,

Nice to see others who have the same problems... I was thinking that I am the only one (like many here, before). 

Firat

Post Edited (favez) : 9/1/2005 5:31:15 PM (GMT-6)

Welcome,

My comments are fairly similar to Leigh Ann's.

It sounds to me if your headaches came back when you stopped Sibelium then I would guess that they're not caused by depression but are a migraine or tension headache. You're on a very low dose of Topamax. I'm up to 75 mg / day and am having minimal success. My neurologist swears by Topamax though feels I need to be on at least 100 mg / day if not 200 mg / day.

I need to take an anti-depressant with Topamax because it does make me crazy. At 200 mg / day I would cry at the drop of a hat. Back down at 75 mg / day and on an anti-depressant I'm fine. I've just upped the dose again and I'm fine, but I waited a long time between increases.

You could also have rebound headaches if you're taking a lot of pain killers or triptans. Headaches first thing in the morning are often a sign. Once you stabilize the preventative medications I would wean off any pain killers. My neurologist says that the Topamax works better without the rebound headaches.

I'm also concerned about your comments about your doctor. I think I have an excellent relationship with my neurologist and family doctor. I am never afraid to ask them anything and both of them always take the time to explain anything I'm unsure about. If you can't ask or tell your doctor something then I think it's time to find a new one.

Good luck!

Thanks very very much to everyone...

The thing is that, my doctor works in another city (the city I was born). But then I moved to Istanbul for university. And now the only way I can talk to him is by phone, which is not the best way I think.

I do not take avmigran/zomig/apranax/cataflam all in one day. Actually now I'm only using avmigran and zomig for pain killing purposes (apranax and cataflam doesn't work, so I stopped them long ago). I usually take about 15-20 avmigrans and 4-5 zomigs a month. But this is in my bad periods. In periods that my headaches are low I really do not use that much drugs. Do you think it's enough to cause rebound headaches?

And Leigh Ann said that caffaine will keep you in rebound. I'm a coffee drinker (3-4 times a day). Coffee gives me temporary relief so I drink it. Can this have any relation with rebound cycle?

I also want to ask one thing about Topamax. My doctor said that Topamax do not cause depression. I was really concerned about that because I really hated the way Sibelium made me depressive. I didn't want to live that again. He said Topamax has no effect of depression, but anyhow he gave me an anti-depressant (Cipram) to take along with Topamax (Cause he thought I may have depression!). So my question is, is it possible for my doctor to hide some information from me (for placebo reasons). Beacuse every medication has different effects on everyone. And therefore doctors do not want to inform people about those effects. Because it might not occure.

Another question about topamax. Does it make you sleep less? For example Sibelium made me sleep a lot. But I'm on topamax for a week, and I gradually see that my sleep need is decreasing. Not that I have any problems sleeping. Just less hours of sleeping at night.

Anyhow, I think the first thing I should do, is to stop all the painkillers. And see if these are rebound headaches. But I woke up with a real bad headache today. It's nearly irressitible. How long should I avoid painkillers to understand?

 

Firat

Firat,

By all means, if you can't stand the pain anymore, take a Zomig.  Please realize that you just started the Topamax, and you must SLOWLY titrate (increase) your dosage to 100 or 200mg over many weeks in order for it to stop the headaches or at least decrease the frequency a significant amount. You should also take an antidepressant like Effexor, as it seems to help the Topamax out somehow.

Most migraine sufferers start out being able to handle headaches with over the counter medications.  Over time, you get use to these and start taking more and more because you don't think the original dosage works anymore because the headache is coming back.  This is when you start to give yourself rebound headaches.  Then you escalate to medicine prescribed by a doctor.  The same thing can happen with the medicine he prescribes, if you keep upping the frequency  or dosage.

What I recommend to everyone is to keep track of your headaches in a journal - when you had headache, time of day, how long it lasted, weather/environmental conditions, medication taken, dosage and time taken, and especially what foods you have been eating.  You really need to find out what is triggering your headaches and this journal should be able to show you some patterns over time.

I know you probably don't want to hear this, but caffeine is that big of a headache trigger and rebounder.  It is the usual guilty party that causes you to wake up with a headache.  The temporary relief you get drinking it is not worth the headache that's going to hit later on.  Granted, I'm not saying eliminate it entirely, just try to cut down as much as possible.  That way you can have a cup of coffee occasionally to enjoy it, not because you are trying to rid yourself of an awful headache.

By the way, have you found a doctor to see you in person while you are at University, or are you making trips home to see your regular doctor?  Jest curious.

Let us know how thing are doing,

Leigh Ann

It's morning here. Last night was the deepest pain I ever lived. I struggeld not to take zomig but at 20:30 it was impossible. And what's worse, it was to late for zomig either to ease the pain. So I ended up in dark, trying to sleep, with this huge pain till 23:30... I even thought of going to hospital. Whatever, you know all about this, don't you?

Now it's 6:54 here. I think I passed out around 23:30. The pain has nearly gone, but there is the weight feeling. Nicky, I will try to find the painkillers you told, but I don't know if they sell them in Turkey (maybe they sell them with another name, I have to investigate this).

By the way I, cut the coffee. I bought coffee wihout caffein, I think it works. And I will try to find a new doctor here in Istanbul...

Thanks to everyone... I will keep you posted...

Firat   

I can find a new neurologists here. But over the years I've seen so many neurologists, and I'm kind of exhausted to see a new one. The thing is that they never tell you about rebound headaches or other stuff like that. Yesterday when I called my neurologist on th phone, I said to him that I tried to cut the painkillers but had a real bad night, and he said to me "don't believe everything you read, take the painkiller if you need". But I really do believe that there is a possibility that my headaches are rebound. Doctors may be hiding this fact, because they are selling drugs.

Anyway, I cut the coffee, I cut the avmigran (which is an ergotamin, and it has caffein, therefore it has high risk of rebound). I will only take zomig or relpax when the headache is very very bad, and I will try not to take more than 3 a week. I also bought Aleve today, but I'm not sure about that, because it's a naproxen sodium which is said to be causing rebound also. Is it really rebound-free?

I think Todarol is not available in Turkey, but there may be a different drug that has the same context, I have to search about this.  

Thanks a lot for the advices.

Firat 

Hello there Favez:

I was reading your history on the headaches that you have been suffering for seven years now. From 1990-1996 my doctor had me taking Sibelium and it did not work to reduce the migraines but he insisted that I stay on it. I did not get the depression side effects that you did, however, one thing concerns me about your history.

First, did you just go off sibelium cold turkey or did your doctor graduate you off of it slowly? I ask only because my doctor graduated me off of it but not slowly enough and I ended up having worse headaches than I'd had before -- I've suffered migraine headaches since as far back as I can remember -- two years of age.

Secondly, it sounds to me like you may be currently having a 'lupus' type of headache which really nags and never leaves. This can be brought on by a sudden drop in the level of the drug, sibelium, in your bloodstream.

Your headaches sound almost like 'environmental issue' headaches. I'm curious about sever things that may or may not relate: 

1.  have ever tried all natural fabrics in your bedroom and on your person.

2.  do you have carpeting in your home and if so, is there euria in the backing

3.  have you tried the process of eliminating foods from your diet

4.  have you ever tried any natural supplements to control your headaches

5.  did your doctor suggest that your headaches were rebound

A bit about me. My headaches are migraine -- they were not properly diagnosed for over 20 years. I did not suffer during my pregnancies and was free of them for a short-lived four years after radical surgery for cancer. It is my environment that causes my migraines and/or cluster headaches (much worse than migraines). Toxins in the air such as scented or fragranced deodorant, hairsprays, shampoos, hair gels, body washes, cleaning chemicals, gas(s), diesel fuels, cigar/ette smoke -- the list is pretty long.

I found that naturalizing my environment four years ago relieved my migraines to almost nil per year. Then I had to move and am in an duplex now with carpeting. Bad migraines back again. This week, my doctor prescribed Zomig for me. I have just taken my second tablet to see if I can break this migraine that began yesterday when we had a gas leak at work. I am typing this to you as I test  zomig to see if it would be usable for me in the work place so that I don't have to miss work.

Has anyone on this forum been using Zomig RapiMelt for a prolonged period. If so, would you consider sending me the pros and cons you have found with this medication.

Favez, I hope to get a reply from you so that I can find out how you are doing and wish you well. Take care and be well -- as well as you can.

Annie.....

Hi Firat,

I, too, have chronic daily headache and have for many (17+) years. It sounds to me like you are suffering rebound, from the aspirin and other painkillers. Naproxen (Aleve) is less likely to cause rebound, according to my neurologist, but can still be problematic if you take it often. I've stopped all nonprescription pain relievers. I've been able to cut my painreliever use down to 15 per month (I use fioricet, which is a combination muscle relaxer, tylenol, and caffiene - the only thing I've found which helps). Of course, that often leaves me with nothing to take on headachy days, and it was a rough adjustment period until I got past the rebound headaches.

Topamax has been a godsend for me. After years of trying dozens of different meds, it's by far the most effective one. I noticed today that I haven't even touched this month's supply of Fioricet -- I'm still using last month's allotment! Of course, I still have my bad days (like today -- a storm front is moving through, which often triggers a headache for me), but the day in/day out headaches are so much less severe and don't really interfere with my daily life too much anymore.

However, it took nearly 4 months from the time I started Topamax until I started feeling results. At least one study I've seen has found that it is normal for it to take 3 or more months to get results from Topamax.

The first month or two was gradually increasing from my initial dosage of 25 mg. to a dosage of 100 mg. You want to increase the dosage slowly to give your body time to adjust to the many possible side effects of the drug. As you'll see from reading the many threads on this and other discussion forums, many people simply can't tolerate Topamax, but a slow dosage increase can help I'm now at 175 mg and am moving up to 200 mg to see if I can get even more improvement.

Interestly, my neurologist wants me to get off the anti-depresant I've been on for years for headaches, thinking I probably don't need it since the Topamax is working so well. I'm a bit reluctant to stop it, in part because I've become reliant on it to help me sleep (of course, that also makes me want to get off it -- I hate being so reliant on it!)

A warning about Topamax -- kidney stones are a real possible side effect and they are NOT FUN!!! Be sure to drink LOTS of water if you are on Topamax -- like 2-3 liters per day or more. Since I've increased my water intake, I haven't had any stone problems.

Good luck -- I hope it helps to know that there are a lot of us who are going through the same pain and frustration that you are and that even after years of unsuccessful searching for a solution, many of us do find some measure of relief!!!

 

Post Edited By Moderator (Annuk) : 9/22/2006 10:34:55 AM (GMT-6)

My apologies, Ann. I've now cleared it with the site administrator and here's the link to the article about a study in Germany about Topamax taking 4 months or longer to be fully effective for chronic daily headache. This link works for me; let me know if others have trouble with it. http://www.docguide.com/news/content.nsf/news/8525697700573E188525709D005434DA?open&id=48DDE4A73E09A969852568880078C249&count=10

Kymark

Strange - you might try going to the docguide.com webpage and using their search engine to look for the article title "Topiramate Efficacy for Treatment of Chronic Tension-Type Headache".

Hi Annie,

 

First of all sorry for the late reply (I was on a holiday) and thanks a lot for your post. I will try to answer your questions one by one.

 

1- Actually I was taking 2 tablets of Sibelium a day, and my doctor told me to take one a day for a week before I cut off. So I don't know if this is slow enough, but my dosage was not high. I don't think this is lupus, because before I started to take sibelium, the headaches were already daily. After I quit sibelium, they return back. But the fact that I quit sibelium didn't make a change in the quantity or the quality of the headaches. It was the same nightmare that I had before using sibelium.

 

2- The thing is that I changed 3 houses in these 8 years (and every one of them had different structures in carpeting or electricity...) so I don't think that the aches are related to the environment I live in. But nevertheless now I try to sleep away from computers and all that though it doesn't make any change.

 

3- I didn't try to eliminate foods. I just tried to eliminate coffee (with caffein) but after a while (about 3 weeks) I realized that it doesn't make a change so I start consuming coffe with caffein again (now I drink 3 mugs a day).

I’m also a smoker and I didn’t try to quit smoking. Because the fact is that my headaches began 8 years ago, and by that time I was a really wild ‘cigarette-hater’. After 4 years of daily headaches, I started smoking (don’t remember how I started but it was during a depressive period). Therefore I don’t think this is related to nicotine. I try to smoke less, but it doesn’t make any change in the number or the strenght of headaches. Nowadays I smoke 10-12 cigarettes a day (before, it was 20-25).

The thing about eliminating foods is that I don’t know which ones to eliminate. Everyone says different food names about the issue. And I can’t decide whic one to eliminate. Neverthless I try to eat foods whit less oil and salt. And I try to eat less meat and try to consume more vegitables, but it is not a strcit diet.

 

4- I tired natural supplements (calcium magnesium with zinc, and a natural anti-depresant –I don’t remember the name-). They didn’t make any change.

 

5- My doctor suggested that they may be rebound, but he said that they are most probably daliy tension headaches. He gave me Depakin for the possibility of them to be rebound. And he also adviced met to consume less painkillers (Now I take apranax and parol –together-, about 15 a month). Sometimes they help, sometimes they don’t. And my doctor also said that I shouldn’t take drugs like Zomig or Relpax, because he sad that they are migraine drugs, and mine is tension headache, so that I should not use them –he said they can make it worse.

 

6- I used Zomig earlier, and it is really a strong painkiller. It did gave me a relief, but it also made me numb. And there were also cases which it did not work…

 

Up till this week, I was taking 500 mg (one tablet) of depakin and 45 mg of laroxyl. They did gave me a partial relief (the number of headaches decrease, but did not go away). Yet I don’t like the side effects of depakin (too much sleep) so I cut depakin and increase the dosage of laroxyl. Now I am testing 60 mg of laroxyl a day –without any depakin- and it seems that it works. The number of headaches decreased. But I’m not sure about this, I have to test it for a month or so. Increasing the dosage of laroxyl made me sleepy during the day hours, but I think it can go away with time…

 

I also discovered something strange about my headaches: The more I sleep at night the more th possibility of waking up with a headache. So I try to sleep not more than 7 and a half hours a day. It does work actually. Yet sometimes when the sleep hour balance is lost (it makes it worse to sleep irregularly –like 4, and the day after 9, the day after 5…) So I try to sleep 7 hours every day. When I lose the balance, the possibility of waking up with an headache increase. Does anyone know anything about the relationship between sleep and this type of headaches?

 

And one more question, is nicotine a trigger for headaches? Is there anything like a ‘nicotine allergy’ which makes your head ache? Like I said before, at the time when my headaches start to occur I was not a smoker, however I’m curious about the ralationship with nicotine and headaches. It can help me to stop smoking J

 

Thanks a lot to everyone…

 

favez    

I forgot to tell you a little about myself. I'm 40 years old, active (3+ days a week) in the gym with cardio and weight training, great cholesterol, blood pressure, glucose, etc. I eat extremely healthy and drink decaf coffee. I have never smoked and don't drink a lot, although I may have a glass of wine in the evening here and there. I work full time and run an efficient household with 4 boys and 2 dogs. My husband works out of town shift work, so he's gone for 3 - 4 days at a time, making me 'single mom' for that time, now THAT is stressful. That's about it in a nutshell...now what is causing these headaches?

I will call my doctor for clarification on the spinal tap. The thing that worries me is I have not had a constant headache until the episode camping...now it won't go away. Before the episode, I'd get a headache or two a week but I could get rid of them. Since the episode, no relief at all, ever unless I take a pain pill so strong it knocks me out or my lunesta which is designed to make me sleep. Like I said, I don't want to mask symptoms either, I want to know the cause. One of the medicines I saw had a great chance for causing gallstones. I already have them although they don't cause me any problems but I wonder if I took the medication would it cause them to start causing problems?