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What Causes Severe Headache Despite Taking Medication?
Question: Dear Sir, I am a Severe migraine patient from last 20 years. My doctor has advised me 1) Dayo OD 500 2) Tryptomer 25 mg OD 3) Cardimol plus 10 mg OD all three tab to be taken at bed time and on onset of headache Tab. Ultracet + Naprosyn-P. But from last 15 days i am having severe pain and getting not relief from Ultracet and Naprosyn-P, in fact last night i had been injected Tramadol. Today morning i got up fresh but as time passed my head started feeling heavy and from my past experience i can feel that this would lead to severe pain resulting as if my my right eye would fall out. I seek advice that should i take another pain killers like earlier i used to get relief from combination of Dart Tab. and Nimulslide Tab also i am worried about the kg of pain killers i have taken from the last 20 years. My self male , age 38 yrs , weight 85 kg height 5 feet 8 inches.
Brief Answer:
Abortive antimigraine therapy seems inadequate
Detailed Answer:
Hello, Sir.
I can certainly understand your concerns.
As per your description you possibly seem to have a relapsing prophylactic form of Migraine.
Therapy for migraine is classified as Abortive and Prophylactic forms.
You rightly prescribe highly efficacious prophylactic therapy.
Whereas abortive therapy seems inadequate.
I generally recommend my patients oral tablets of drugs called triptans.These are known to abort acute severe headache episodes.
Please check with your physician if he shares my view and if can prescribe them to you.
You also seem to ingest a large quantity of analgesics over a time period.
This is definitely not safe as it is known to cause peptic ulcers and kidney disease.
It is advisable to reduce the dosage and frequency of analgesics by substitution of triptans
Post your further queries if any.
Thank you.
Abortive antimigraine therapy seems inadequate
Detailed Answer:
Hello, Sir.
I can certainly understand your concerns.
As per your description you possibly seem to have a relapsing prophylactic form of Migraine.
Therapy for migraine is classified as Abortive and Prophylactic forms.
You rightly prescribe highly efficacious prophylactic therapy.
Whereas abortive therapy seems inadequate.
I generally recommend my patients oral tablets of drugs called triptans.These are known to abort acute severe headache episodes.
Please check with your physician if he shares my view and if can prescribe them to you.
You also seem to ingest a large quantity of analgesics over a time period.
This is definitely not safe as it is known to cause peptic ulcers and kidney disease.
It is advisable to reduce the dosage and frequency of analgesics by substitution of triptans
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Prasad
Dear Doc.
I hope you have understood the medicines i am taking as in my earlier mail i had mentioned the brand names. For further details i am mentioning there generic names 1) Dayo od 500 generic name divalproex sodium 2) cardimol plus 10 generic name flunarizine dihydrochloride 3) tryptomer 25mg generic name amitriptylne hydrochloride 4) ultracet generic name tramadol acetaminophen 5) naprosyn-p generic name naproxen paracetamol. I seek your advice that are these medicines right for my cure and should i continue with them. Or should i start with your prescribed drug (triptan) alone or should i add up triptan with my old medicines.
Also please mention any brand name for triptan and its dose. Please does also suggest effective and strong medicine on for headache which has lesser side effects.Is taking pain killers through injection is more safe compared to orally and what other general precautions should i take to avoid such pain.
Thanks N Regards
I hope you have understood the medicines i am taking as in my earlier mail i had mentioned the brand names. For further details i am mentioning there generic names 1) Dayo od 500 generic name divalproex sodium 2) cardimol plus 10 generic name flunarizine dihydrochloride 3) tryptomer 25mg generic name amitriptylne hydrochloride 4) ultracet generic name tramadol acetaminophen 5) naprosyn-p generic name naproxen paracetamol. I seek your advice that are these medicines right for my cure and should i continue with them. Or should i start with your prescribed drug (triptan) alone or should i add up triptan with my old medicines.
Also please mention any brand name for triptan and its dose. Please does also suggest effective and strong medicine on for headache which has lesser side effects.Is taking pain killers through injection is more safe compared to orally and what other general precautions should i take to avoid such pain.
Thanks N Regards
Brief Answer:
Triptans are advisable
Detailed Answer:
Hello, Sir.
I can certainly understand your concerns.
I apologize for the delayed response owning to my hectic work schedule.
I have gone through your drug profile in detail.
Drugs 1 to 4 are mainly indicated for prophylaxis of migraine. This part is very much okay.This is a form of maintainence therapy.
Drugs 4,5 are useful for abortive therapy in acute headache situations.But here Triptans should have been added. Since 4,5 are alone not sufficient for effective results.
I generally recommend my patients oral tablets of Sumanet/sumatriptan 50 mg for acute abortive therapy. Naproxen is usually combined with sumatriptan and advised. Tab ultracet can be discontinued as it confers no additional advantage.
It is advisable to start Sumatriptan after discussing with your physician. Please check if shares my view and if can prescribe them to you.
Intramuscular injections of pain killers on long-term can cause kidney dysfunction although it doesn't cause peptic ulcers.
Migraine is generally prevented by
Avoiding foods like chocolate and cheese.
Avoid exposure to bright lights.
Maintain darkness while you sleep.
Avoid stress and red wine.
Avoid high salt junk food.
Post your further queries if any.
Thank you.
Triptans are advisable
Detailed Answer:
Hello, Sir.
I can certainly understand your concerns.
I apologize for the delayed response owning to my hectic work schedule.
I have gone through your drug profile in detail.
Drugs 1 to 4 are mainly indicated for prophylaxis of migraine. This part is very much okay.This is a form of maintainence therapy.
Drugs 4,5 are useful for abortive therapy in acute headache situations.But here Triptans should have been added. Since 4,5 are alone not sufficient for effective results.
I generally recommend my patients oral tablets of Sumanet/sumatriptan 50 mg for acute abortive therapy. Naproxen is usually combined with sumatriptan and advised. Tab ultracet can be discontinued as it confers no additional advantage.
It is advisable to start Sumatriptan after discussing with your physician. Please check if shares my view and if can prescribe them to you.
Intramuscular injections of pain killers on long-term can cause kidney dysfunction although it doesn't cause peptic ulcers.
Migraine is generally prevented by
Avoiding foods like chocolate and cheese.
Avoid exposure to bright lights.
Maintain darkness while you sleep.
Avoid stress and red wine.
Avoid high salt junk food.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Answered by
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