Meds & Supplements, Treatment, Triggers

Why I’m Doing Better, Part 1: Climate & Medication

After my recent glowing posts, many people have inquired why I’m feeling better. I’d like to give you a clear, definitive answer, but migraine is never that simple. There are a number of factors, from climate and medication to exercise, meditation and forgiving myself for being sick. I’ll talk about the first two today and the others, which have probably had a greater impact on my health and suffering than medication, later this week.

Climate
Moving to Phoenix, away from the clouds and rain of Seattle and the ever-changing weather of Boston, has had the biggest influence on my migraine frequency, duration and severity. Storms and clouds have been rolling through Phoenix the last week and I’m on migraine day six. Though migraines aren’t always present when there’s weather, particularly if I’m on vacation, the correlation holds about 90% of the time. I wonder if the issue is barometric pressure changes, though Seattle’s barometric pressure is relatively steady, so parts of my hypothesis fail there.

Indomethacin
I began taking this nonsteroidal anti-inflammatory drug in June because the sand-in-my-eye symptom pointed to the slight possibility that I had an abnormal presentation of hemicrania continua. This rare headache disorder is completely responsive to indomethacin. Though my headache pain lessened, it did not cease, which means my diagnosis is still migraine. My doctor kept me on a daily dose of 225 mg of the medication, though he warned that it is not recommended for long-term use as it is hard on the stomach. I’m sticking with it for now because it is the only medication on which I’ve noticed a decrease in the frequency and severity of my migraines.

Discontinuing Wellbutrin and Lamictal
In 2005, I was prescribed Cymbalta, Wellbutrin and Lamictal for depression. I stayed on them far longer than I intended, especially considering that I was still majorly depressed while taking them. I finally went off of them this summer after determining that my dizziness, tremor, hot flashes, fatigue, cold hands and feet, mental fogginess, nausea, and increased pulse were not migraine symptoms, but medication side effects. I believe Wellbutrin was the culprit, but I wanted to stay off all three if I could. When my depression symptoms returned, I went back on Cymbalta. I’m happy to say that the depression is at bay and I’m not experiencing any other side effects.

Namenda
I’m in love with this medication, which is an Alzheimer’s treatment that is used off-label for migraine. I don’t know if it has had an effect on the migraine severity or duration, but it has cleared the mental blah that has plagued me as the migraines worsened. I credit Namenda with returning the mental wherewithal necessary for me to resume blogging and restoring my sense of intelligence. The feeling dumb aspect of migraine, which is not addressed frequently enough, has been one of my most limiting symptoms and has caused the greatest loss of my sense of identity and purpose. Did I mention that I love this drug?

Meds & Supplements, Treatment

Name Brand and Generic Midrin Discontinued

Update 10/28/2018: Midrin and Midrin equivalents have been completely discontinued under FDA orders. (Learn more in this article: Say Goodbye to Midrin and Midrin Equivalents.) You may still be able to get what you need from a compounding pharmacy.

When I tried to fill my Midrin prescription today, the pharmacist told me that all formulations of the drug have been discontinued. Migraineurs throughout the US have heard the same news over the last three years, though the trouble has become more acute in recent months. Migraine advocate Teri Robert researched the issue and confirms the reports. Midrin, Amidrine, Duradrin, Epidrin, Isocom, Migquin, Migrapap, Migratine, Migrazone (all brand names of meds with the same ingredients as Midrin) and the generic isometheptene mucate/ dichloralphenazone/ acetaminophen have been discontinued.

Midrin appears to be a casualty in FDA’s attempt to subject all medications to current approval requirements. Teri explains,

“Midrin was first made and marketed before the current FDA drug approval process was in place. It was never reviewed by the FDA for efficacy and safety. Nor were any of the other similar products. And that’s where the problem lies.” …

“The loss of Midrin as a treatment option isn’t good news for us. The likelihood of any company investing the time and research dollars necessary to apply to the FDA for a drug equivalent to Midrin is slim. Yes, many people are still using it, but far fewer than before the triptans were developed, and triptan usages is up. The cost of triptans is down since two of them are now available as generics.”

Read all of Teri’s article, including her correspondence with an FDA official, on Help for Headaches & Migraine. Many thanks to Teri for her excellent sleuthing and dedication to helping migraineurs.

I’m crushed to learn that one of the few drugs to provide me with any relief is no longer available.

Update: The Midrin equivalent is once again available as of late 2011. Not all doctors and pharmacists are aware of this. If you are told Midrin isn’t available, tell them that Macoven Pharmaceuticals makes a generic equivalent and ask them to look into it.