Further advice preferable, failing everything

Well, I've tried going to a chiropractor, physiotherapist and optician. Body is working alright now that I got myself some contact lenses. I have been to a neurologist three times and my general practitioner countless times. I have tried to stop caffeine, cheese, chocolate and other triggers. I have always been cautious to sleep and eat regularly. The neurologist said that I have a stubborn migraine. First time I went to the neurologist I was 11 years old and I was then prescribed Imigran Juvenil 10mg nasal spray, and I have from then on used triptans until now, age 17.

Basically, I have migraines over 15 days a month(chronic) and I have used many triptans; Sumatriptan(suppository, nasal spray, pill 50mg/100mg, injector 6mg), Rizatriptan(10mg orodispersible tablet),Eletriptan,(40mg pill), Zolmitriptan (orodispersible tablet).

Painkillers that I have used: Naprosyn (1000mg), diclofenac potassium 50mg, paracetamol 1000mg, ibuprofen 600mg.
Preventative medications that I have tried are; Lisinopril(ACE-inhibitor,not tolerated), Inderal 80mg(beta blocker, 1 month), Depakote 1000mg(Valproic acid, 6 months) and I am currently on nortriptyline 75mg (1 month+).

Things are not working out well, I obviously can't take a painkiller everyday and my only choice of triptan is the imigran injector. I'm failing school and haven't been to school for 10 days now. I have always been depressed but not diagnosed. Nortriptyline helped a bit with that, but it hasn't worked well to prevent my migraines. I have been using melatonin 3mg for 5 months because depakote gave me insomnia. Depakote worked the best of all the medications that I've tried, but it made me feel dumb and less mentally fit. I didn't like that so I ditched it for nortriptyline. Of course that made my migraines more aggressive and frequent so I had to use diclofenac 100mg daily for a couple of days. Now that I've used nortriptyline for a month, I feel no noticeable improvements except for the painkilling and zombifying effect of nortriptyline, although nortriptyline has increased mood and sadly, anxiety.

Now, I don't know what to do,
Any medical advice, people to go to, medications to try, everything is welcome. Feel free to ask question if you'd like.

Starduster said...
Dear beesknees,
I'm new to this forum but very old as far as chronic daily migraine is concerned. Mine began same age as yours and became daily by age 18. This is my first post and I'm not up to writing much now but was concerned you'd had no replies, so far, and I wanted to say don't give up, don't accept everything the doctors tell you without getting well-informed second or third opinions.

One thing you may consider is the perennial question of whether you have rebound pain from regular pain meds, I have been told any sort, even triptans, can cause this. In my case staying off pain meds completely - had to be put in semi-coma to endure it - made no difference, the headaches and migraines continued.

If you are depressed I empathise with the zombie response to nortryptiline; I have tried every preventive, many to extremely high dosages which left me incapable of basic functions. Point to consider is you may not have yet tried SSRIs, anti-depressants which affect levels of serotonin in the brain. 5HTP is a natural supplement which acts in the same way but has not been tested for appropriate dosage. I am currently trialling Sertraline having found the 5HTP a bit weird.

Good luck.

I haven't tried SSRI's yet, however, I don't think they will do much good to prevent my migraines. I do wonder a bit about the potential for me to use it as an anti-depressant though. Nortriptyline is supposed to work just as well and might even better than SSRI's so... I see it as my only reasonable option now is to try topiramate and see if that can prevent my migraines like depakote did or maybe even better. The reason I opted to use Nortriptyline instead of Topiramate is because I don't want to feel dumb as a rock, like I did on Depakote. That is my main fear. I have always considered myself very intelligent, but now as the school work keeps on piling up, I doubt it. I remember my neurologist told me 6 years ago that people with migraines are smarter than people without, but I know that recent studies have busted that myth.

And on the subject of rebound headaches from triptans or pain killers, I discontinued use of triptans and pain killers this summer and did not find it to lessen the frequency and intensity of my migraines. I have spoken with my neurologist and he doubted I had Medication Overuse Headache.

I'm starting to feel like a broken record in my recent replies, so bear with me, but I also just became aware there's a dangerous chemical in 6000 food items and drinks. Aspartame, aka phenylalanine, Acesulfame-K, Amino-Sweet, Nutra-Sweet, Sunette, etc. It can induce headaches and a slew of 91 other ailments/symptoms, some very serious - seizures, brain tumors - it can mimic symptoms of MS. If drink diet drinks, stop, if you chew gum, stop, if you use breath mints, stop, in fact switch toothpaste as well, Sorbitol isn't any better for us than aspartame is (Sorbitol is in a lot of chocolate candy, Crest, Colgate, Pepsodent, Aquafresh). I buy my toothpaste from a health food store now. I read every single label of any product I buy now - from food, to drinks, to cosmetics, to candy, you name it, I am now spending twice as long at the grocery store. I am purging anything in my house with it too - I recently read it's in V 8 juice, lovely, I used to use V 8 in stews and soup, I won't anymore.

The reason I became aware of this chemical, loosely labeled as an artificial sweetener, is because I have lost 50% of the hearing in my left ear from cochlear meniere's disease. My doctor asked if I experienced headaches and migraines, I said yes since I was 16 and I'm 58 now. He said to look up migraine triggers to manage my meniere's more effectively (the two are connected, headaches and meniere's, he implied I was prone for a meniere's dx), aspartame comes up as a trigger.

Avoid aspartame. My doctor said to avoid it like the plague.