Last year during Migraine & Headache Awareness Month, I sang the praises of my favorite triptan abortive and shared my fears that it might one day lose its effectiveness. I have asked doctors many times about switching to another triptan. In the past they have just shrugged their shoulders and told me to “keep using what works”.
A few weeks ago I hit a stubborn round of cluster attacks that eventually landed me in the hospital being pumped full of magnesium, Toradol, and Solumedrol in order to break it. Before we got that far, my neurologist recommended something very unexpected. He instructed me to take Naratriptan (brand name Amerge) twice a day for a week straight. I’d never taken more than 2 or 3 triptans in a single week in order to avoid the risk of Medication Overuse Headache. However, I recently learned from a video recording of Dr. Peter Goadsby that aggressive use of triptans for Cluster Headaches does not carry the same risk of MOH as it does for Migraine. He admitted that no one really knows why this is the case. I was pretty miserable, so I was willing to try just about anything to get a break from the pain.
It worked. By the second dose, the attacks stopped. They stayed away until a few days after I stopped taking the medicine. The best part (at least for me) was that I didn’t have the same severity of side effects with Naratriptan as I had experienced with Zomig. All triptans narrow the blood vessels. Zomig just seemed to do so in a way that left all of my muscles aching and my skin feeling slightly burned for at least a day after a single dose. That really tells you how bad the pain of a Migraine or Cluster attack can be if I’d rather ache all over and feel burned instead of experience the attack.
Still, I had always hoped for a better remedy, one that would last a little longer and not make me hurt quite so badly. I think I finally found it! Even as I write this, it all seems so surreal. I’ve been using Zomig for almost 16 years. To trade it in for another triptan seems…traitorous. I still hadn’t had the opportunity to try it out on a migraine. Would it really work? Was my brief vacation from pain just a fluke? As I was running errands before leaving town this weekend, I got a phone call from the pharmacy. My new prescription of Naratriptan was ready. Did I want to pick it up? Well…I only had one Zomig left. I knew I should pick up the medicine, yet something held me back. I finally relented only because the idea of being stranded 4 hours from home with no abortives seemed like too big a risk to take.
Yesterday evening I got the opportunity to try it out. We stopped for gas, restrooms, and leg stretching when I began to see flashing stars in my peripheral vision, followed by a wave of nausea and that creeping feeling wrapping around the left side of my head. Ugh…on the road and about to get a migraine. Thank God I filled that script! I dug the box out of my purse and fumbled with the packaging, cursing the makers of Naratriptan for making the packaging so blasted hard to get into.
Do they have any idea how hard it is to open that plastic in the middle of a migraine?
Somebody should do something about that!
Finally I pry that precious little $15 white pill from its plastic cocoon and wash it down with a swig of water. Within about 30 minutes I can feel the migraine loosening its grip and begin to slither away. By the time we arrived at our destination, there was no sign that I ever had a migraine. 24 hours later I am still pain-free.
Did I just “fire” Zomig?
This year I am focusing my efforts on building awareness for my “other” headache disorder, Cluster Headaches.