hydrocodone to prevent migraine
There are drugs for treatment of the acute pain of migraine and others to prevent it's occurence.
Treatment of the pain of migraine is best achieved by a class of drugs known collectively as ergots and others known as triptans. A third group, probably less effective, are the opiates which are the traditional drugs for relief of pain ( of any type ). These are less effective because relief of migraine requires a rapid onset of action, a property not not common to most opiates, at least those taken orally.
The prevention of migraine (prophylaxis) can be achieved by a variety of drugs including the cardiac beta blockers, anticonvulsants, antidepressants and a few others. Another group can be very effective also. Surprisingly, it is the opiates!
A 38 year old woman had a history of migraines dating from age 12 had little luck with conventional prophylactics and triptans but discovered that the opiate hydrocodone (Vicodin, Lortab, and others) gave good relief of her migraine headaches. She discovered this, as often happens, when a friend gave her one of her own pain pills. (This sharing of medications is appropriately frowned on by the medical community--but sometimes, I'll admit, we can learn a lot from it.)
She told me she was sleepless and depressed ( common in the migraineur) and that her headaches were a terrible inconvenience, occurring four or five times weekly. I prescribed the anticonvulsant clonazepam and the antidepressant imipramine, drugs she had not been given before and also Maxalt, one of the triptans she had not yet tried. On her return, she reported improvement in sleep and mood but no change in headaches. The maxalt had done no good and she continued to rely on hydrocodone, much the best drug for her headaches.
I have learned that if an opiate can relieve migraine, and it doesn't happen a lot, it can sometimes prevent migraine. I told here to take three hydrocone daily, headache or not. On her return she was estatic. Over the course of the past month she had exactly one headache, that at the time of her period, and an extra hydrocodone relieved it promptly.
I will, in future blogs report on the remarkable benefits of opiates in the treatment of a variety brain things, including depression, migraine, bipolar disorder, obsessive compulsive disorder, and, I am sure, others as yet undiscovered.
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Reply #2 on : Mon May 24, 2010, 13:13:06
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Reply #3 on : Tue May 25, 2010, 09:17:52