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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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    Suggest treatment for severe migraine headache

Hi, I have suffered from migraines from the age of 16, I m now 56. Ive had MRI scans and all is clear, I ve had to accept that i am just a frequent migraine sufferer. I don t drink alcohol and hardly have chocolate, cheese etc. I take 50g of amitriptyline each night to help with the migraines and sumatriptan when i have an attack which is usually effective. However, i have had a recent spell where i have had to take 1 dose of sumatriptan alomost every day for the last 10 days and now even if i do to bed each night headache free, i am waking every morning with a painful head, When i visited the Migraine Clinic in London years ago the specialist told me that she thinks one of the triggers for my migraines might be sinus pain. I also think that i may be getting re-bound headaches becasue of the amount of medication i have taken, Yesterday i woke with w migraine again and decided to go the whole day without medication to see if i could break the cycle. Well its not worked, i ve woken again with the same pain in my head, My questions are: can i take a medicine such as sudafed or sinutab to see if this has an impact on the pain. bearing in mind i take amitriptyline, Reading up on this i think perhps i can t? Also, if i am suffering from re-bound headaches, should i also avoid a standard painkiller such as ibuprofen or panadol? i am struggling to get through these days because to have no pain relief is hard. This is not the severest of migraine but nevertheless it is totally incapacitating. the last time i took any sumatriptan was Thursday morning.
Tue, 9 Jun 2015
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  User's Response
Hello!

Thank you for your question on HCM! I read it carefully and appreciate your concern.

Your symptoms seem to be caused by a chronic daily headache superposed over migraine.

It is safe to take sumatriptan everyday for the prevention and treatment of migraine when the preventeve therapy is not very effective. I would first recommend you to try to switch from amytriptiline into another preventive treatment for migraine like topiramate or valproate. It seems that amytriptiline is not that effective in preventing your migraine attacks.

I would recommend you to consult with the ENT specialist and have a brain CT scan and sinus discharge culture to examine your sinuses. I don't think that taking sinutab will help. It contains acetaminophen, which like ibuprofen and panadol can cause chronic daily hedache drug induced.

Hope to have been of help!

Greetings! Dr. Aida
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