WOMENS-HEALTH Messages for April, 1997: Re: Migrains

Re: Migrains

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Sun, 20 Apr 1997 14:29:48 -0500 (CDT)

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At Fri, 18 Apr 1997, Debra wrote: >
>My migraines are directly related to my cycle. I've been to many
>different GYN's and Neurologists. I have yet to find an solution to the
>pain. I've tried imetrix, cafregot... the list goes on. I've have all
>the test including an MRI. When not on the pill, I experienced dots and
>lines in my vision along with my headaches, so I went back on. When on
>the pill I still get headaches on my "off" days. My latest attempt from
>a GYN was to put me on Depo Prevera. This helped only about 10% more
>than the pill, however, I've been a little depressed (no up or high
>days), irritable, and I have absolutly no sex drive. My search has
>lasted over 8 years. I'm very frustrated. I feel like no doctor wants
>to deal with me the GYN's send me to the Neurologist and vice versa.
>What do I do next? Someone else must have the same problem.

Debra, My heart goes out to you. Not only do I treat these as a physician, but it runs in my family - 5 generations - menstrual migraines mainly, but at other times too. I know how this can affect your ENTIRE life. I don't know if yhou've tried the following (since it seems like you've done everything possible so far) but here goes: Caveat - These are daily medications used as a preventative.

Inderal (and if unable to take for a variety of medical conditions or if it didn't work):

Verapamil (a calcium channel blocker for hypertension, found out by coincidence to prevent migraines)

Amytriptiline (an anti-anxiety medication which is used to potentiate (make it work better) the Verapamil)

Sansert (serious side effects including pulmonary fibrosis (treatment limited to 6 months))

Periactin (major complaint is weight gain - I mean major!)

If, indeed your body is responding a change in hormones rather than a drop in hormones, constant hormone therapy with a withdrawl bleed every 4 months (this is safe) can be done. Also, some people have written about pre treating the menstrual migraine to prevent it.......kind of like pre treating a stain so it never forms. Medications like Motrin 800mg or Anaprox DS can be used, starting treatment 2-3 days prior to when you expect your period/migraine. This has worked on a significant number of my patients. Good luck with this vexing problem.

-- Harvey S. Marchbein, M.D. FACOG, FACS OBGYN.net U.S. Representative, New York Great Neck, New York

*Note: Opinions expressed here are for educational purpose only. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options.

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