Another visit to my headache specialist, another round of medications and therapies. This is the first time I don’t have any anticipatory excitement that one (or some) will help. It’s not that I don’t think there’s a chance, I’m just too tired to get caught up in what ifs.
The prescriptions I left with are for Migranal, an abortive, and Seroquel, a preventive. I’ve never tried Migranal as on-the-spot abortive. I did use it when a three-week intensive treatment of injectable DHE caused muscle pain. (DHE and Migranal are essentially the same drug, just in different delivery forms.) That three-week treatment was cut short after I failed to respond even the tiniest bit.
Seroquel has been on my mind since reading this success story. I know what works for one person doesn’t always work for another, but I needed to ask. Since I’ve tried multiple meds in all the classes of drugs used for headache with no success, my doctor and I decided it was worth a shot. It can be sedating, but I have to wonder if being sedated with less headache would be better than the exhaustion that accompanies a migraine. (I need to read the full side effect profile before I fill the prescription.)
Biofeedback and headache management therapy are the other two treatments I’m going to try. That’s right, I have never tried biofeedback. I feel like an impostor writing a headache blog without trying it. I’ll be able to shed my shame soon.
Even though I don’t really know what it is, headache management is what I’m most excited about. Apparently I will learn tricks to help when I have a bad headache, like massage and neck exercises.
As I write this, my head is bad so my outlook is bleak. Whenever I have a low migraine, low pain, high energy stretch, like I did last week, I return to “normal” with a thud. Having had a total of three good weeks in the last two months, I now believe I’ll have more migraine-light days in the future. But I quickly grow impatient for the next time to arrive.
8 thoughts on “A Visit to My Headache Specialist: Migranal, Seroquel, Biofeedback & Headache Management”
I’ve been on Seroquel for approximately 4 years; 300 mg/day taken at bedtime. After 20+ years of chronic cluster headaches, I have been in remission since 3 weeks after starting on Seroquel. The only side effect I’ve experiences is elevated glucose levels, which I have been able to keep in check through diet and exercise. I had tried a number of abortives (basically all of the triptans; none worked) and preventives (Verapomil, litium, Depakote, Topomax) prior to Seroquel; nothing helped.
Based on my experience, I would recommend trying Seroquel when other options have not worked. As always, try the things with the least onerous side effects first and work your way down the list from least risky side effect profile to most risky.
I came across your sight by accident, while searching to see if my doctor was hit by a car the morning he prescribed me seroquel! When I saw what the primary purpose it is for I thought he was absolutely crazy! In fact, I decided to stop taking it until I did my research to see if migraine sufferers have been taking it. After suffering for 10 years with about 4-5 migraines every week, passing out often, now during the last 1 1/2 years add seizures to the mix and several medicine margaritas, I’m game to trying almost anything.(By the way, all that time they didn’t know what type of migraines I had.) But the seroquel was a bit different. I know now (as of 6 months ago,) that I have Basiliar Artery Migraines. Any advice I would gladly take.
Yes please try the biofeedback – you’ve tried so many things already!
But not just the usual biofeedback hand-warming thing. Try HEG brain-based biofeedback. You should know within 6 sessions whether it’s making a difference and it has an amazing success rate of over 90% for folks who hang in there for at least 6 sessions. (“Success” meaning a personally meaningful decrease in intensity and/or number of migraines.)
If I may be so bold, I have an article on my blog called “Do you need to tolerate migraines?” that describes HEG neurofeedback. The url is:
I have a client right now who has gone from 2-3 migraines/week that incapacitated her to maybe 2 per month that she can work through. She is furious that no one ever told her about neurofeedback, so I’m just trying to do my part to spread the word. 😉
Please do try it and share how it works for you!
Thanks for the terrific information. I’ll be sure to check out your blog post too.
The reason I like prescribing Seroquel is that the risk of extra-pyramidal adverse effects is so low, and the risk of weight gain is very low.
Sedation should be minimal if you take it at night, and build the dose gradually.
*keeping fingers crossed*
Similar to you, I used to be excited each time I went to the doctor with the hopes that he would suggest something that would work. Over time, that excitement has faded as time and again new rounds of medications don’t work.
I’ve tried Migranal. I’ll be interested to see how it works for you. I’ve not heard of Seroquel, but I’m going to look into it!
I’ve also been trained in biofeedback. I’m not convinced it helps prevent migraines or lessens the pain of cdh, but I do use it when I have a migraine to help take my mind of off the pain and relax the rest of my body.
I’ll be interested to hear if you decide to try Seroquel. I’ve tried a range of preventives myself and keep eyeing Seroquel, however the risk of tardive dyskinesia scares me. Reading about the adverse reactions over here makes me wary: http://www.healthyplace.com/communities/depression/bipolar/seroquel_3.asp
However, the folks over at http://www.crazymeds.org are pretty positive about Seroquel and say that the risk of extrapyramidal side effects is very low.
Good luck. I’m on the “let’s try another med” carousel myself and I know how frustrating it is.
(Oh, and I just started biofeedback myself. No results to report yet, since I’ve only had one session.)
Thanks for the encouragement. I’m nervous about trying it too. We’ll see if I ever do.
I hope biofeedback goes well for you.
Sorry to hear that you’re having to play the “let’s switch around your meds” game… I’m anticipating/hoping that I do that this Thursday at my appointment with my [new] doctor at my regular headache office. My stuff just doesn’t seem to be cutting it. I’m hoping that you have luck with your new meds. I tried Migranal (prescribed by a myofacial pain/TMJ specialist I had in 05) but it didn’t do anything for me, hopefully you will find otherwise!
It’s certainly tough to have any kind of outlook other than bleak when we’re hurting, but I hope you’re able to keep your chin up… it’s what I’m struggling with. Let us know what happens!
Thanks for the support. It means a lot to me. I wish you well at your appointment on Thursday.
Sorry things have been so rough. Hope the new meds work well for you!