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Depression, Illustrated

I’ve only mentioned my Lyrica trial in July briefly. I was on a low dose of the drug for 10 days and it took nearly a month for me to recover from the massive depression it triggered. Fortunately, I was aware that antiepileptic drugs can worsen depression and cause suicidal thoughts, so I knew that the medication was the culprit.

Having a medication change they way you think is scary, though not as terrifying as when the thoughts seem to come out of the blue, as they seem to with a typical depression. Hyperbole and a Half brilliantly depicts how depression can hijack your thoughts. The cartoon is worth a look if you or anyone you know struggles with depression, which pretty much covers everyone.

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Epilepsy Drugs (and Headache Preventives) Explained

The Epilepsy Therapy Development Project‘s website has the most comprehensive information on anticonvulsants that I’ve seen. It is thorough and broken down in a clever way, so that you can see the basics or intermediate or advanced information.

Here are links to the site’s descriptions of epilepsy drugs that are frequently used migraine and headache preventives:

Many thanks to Pam for pointing out the site!

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Lyrica, Sleep and Chronic Pain

In studies of Lyrica’s effectiveness for fibromyalgia and shingles pain, participants have reported sleeping better while taking Lyrica.

On his RevolutionHealth blog, sleep specialist Steve Poceta wrote:

Lyrica has been shown to improve sleep in certain patients who have pain, such as fibromyalgia and shingles pain. However, it is also important to assess the effect of a drug on the sleep of normal sleepers, because the sleep of patient groups is by definition already abnormal.

Dr. Poceta also describes the stages of sleep and how different drugs target different areas. Although I had trouble summarizing his points, the explanation isn’t hard to read or understand. I recommend reading it.

For anecdotal evidence, a reader told me that since starting Lyrica in January, her migraines have gone from 3 or 4 times a week to about once a month. Her insurance won’t cover it, even after having her doctor appeal the first decision.

She spends $100 a month on the drug, although she just found a pharmacy that carries it for $72. Proof that shopping around is valuable!

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Update on the Migraine & Chronic Daily Headache Treatments I’ve Tried Since February

I’ve tried a variety of treatments since February, but haven’t kept you updated. It’s like I don’t want to talk about them at the outset because I might jinx it. After a treatment has failed, I push it aside so I don’t have to think about it. Here’s the surprisingly long update.

Naturopath
Shedding tears in the naturopath’s office the first time was enough to keep me from seeing her again. Against my hard fast rule that I not take anything I can’t identify (which I also broke with the acupuncturist), I took the homeopathic remedy, vitamin D and magnesium supplements she suggested. They did nothing.

Chiropractor
I gave the chiropractor two months, which is the maximum time she told me it would take to see results. I went five times one week, four the next, three for a couple weeks and so on. Turns out I hold my adjustments very well. Unfortunately my migraines didn’t changed and having my neck adjusted freaked me out. Once she stopped asking about my headaches and focused on pain in my lower back, I knew she had given up.

By treating me as a challenge for which she was sure she had the solution, the chiropractor made the classic mistake of nearly every “alternative” care provider and many physicians I have seen. That always makes me laugh, but leaves me wary that the overconfident provider is setting him or herself up for a fall. Which is what always happens.

Sleep Specialist
Many people with treatment-resistant headache disorders become much more treatable once they have sleep problems resolved. Although my sleep seemed fine, I saw a sleep specialist with a background in neurology. Sadly, my sleep is practically perfect. I sleep eight hours, wake up rested, nap when I need to without having it interfere with that night’s sleep.

New Headache Specialist
A Seattle-based headache specialist that I’d never seen before was recommended highly, so I saw her in May. We hit it off immediately. Too bad we focused on my blog, headache patients in general and clinical trials. I left enrolled in a clinical trial for Lyrica and with a potential advertiser for The Daily Headache, but without having discussed any of my questions or other treatment options.

I already had Monday’s appointment with my first Seattle headache specialist, so I didn’t make another appointment with specialist #2. Seeing specialist #1 again reminded me that she’s the right doctor for me.

Lyrica Trial
In the spirit of giving back — and possibly finding an effective drug — I enrolled in a clinical trial of Lyrica. Currently I’m keeping a headache diary and am to start the meds (Lyrica or a placebo) at the end of the month. I’m pretty sure I’ll drop out before then.

Six months, the length of the study, is a long time to wait before I can get a prescription and test Lyrica out on my own. I have other treatments in the works and don’t want to confound the equation. Besides my impatience makes waiting more than a year to find out if I took Lyrica or the placebo agonizing. I can’t decide.

Wheat-Free, Dairy-Free Diet
This one needs it’s own post, which I’m working on. In sum, it looked like there could be a connection, then it looked clear there wasn’t. Now I have no clue.

That’s the update. Disappointing, huh? I have another round of ideas percolating. They seem like good ones this time, not acts of desperation. We’ll see.

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Unexpected Migraine Treatments

Even when you feel like you’ve tried everything, there’s almost certainly more out there. This is something I’ve been posting about and e-mailing people a lot lately. Without knowing everything they’ve tried, it’s hard to point someone in the right direction.

Top 10 Unexpected Migraine Treatments, a HealthTalk webcast scheduled for Wednesday, April 18 will get to right to the point. Guessts will be Brian D. Loftus, MD and John Claude Krusz, MD PhD.

In the meantime, here are some other resources:

A fairly comprehensive list of available preventive and abortive medications, including some of the newer ones, like Lyrica and Cymbalta. (These websites describe the drugs, but don’t talk specifically about headache. They are both prescribed off-label (read comments at this link) as Topamax was for a long time.)

The National Headache Foundation‘s podcasts: The Condition of Migraine, Symptoms and Triggers, Migraine Treatments, Latest Migraine News and Information. It’s good stuff, particularly the one on migraine treatments (not surprising, huh?).

The American Council for Headache Education has a collection of articles on treatment (the second heading on the page). They cover a wide range of topics, but some of the articles are old. If something catches your eye, I recommend doing some further research on the topic. I’m happy to answer questions when I can.

The World Headache Alliance also covers various treatments. Most topics are supported by recent research. Non-Pharmacological Therapies. The Treatments section covers a huge variety of topics. They include studies that contradict each other, which is good to get both sides. Check out the news section, too.

Sorry for such a link-heavy post!