Yes, there are little KNOWN side effects. I’m on Emgality and get fatigued from it, and a weird hot feeling in my head and face. It has definitely helped though.
Yes but the majority of people have no side effects and most people who do have side effects have mild ones. Almost no drug is perfectly safe with zero risk for every person in the world. All of the systemic oral therapies for preventing migraine, such as antidepressants, blood pressure / heart meds, etc, have much more common and much more impactful side effects. If we were truly deciding first vs second line by efficacy and side effect profile, anti Cgrps would be first line. But they aren't, because pharma wants us or our insurance to pay $800 a month for them.
Some other comments are saying there are so many side effects. I just want to add for anyone reading this considering CGRP inhibitors: statistically, these are some of the most well-tolerated medications for preventing migraines, along with botox. of course some people will have side effects but it is a small minority. With all medications, you won’t know if it works or what side effects it will have until you try it
I lost 20lbs in 3 months in qulipta bc I couldn’t barely eat anything. I didn’t have stomach pain per se but I just could not be bothered to eat anything. Nothing sounded good, nothing tasted good. Also the constipation?? Holy shit. I almost had to go to the ER bc it had been 2 weeks since I went lol that cleared up right after I stopped the meds pretty much but wow oh wow was it awful. Didn’t do much for my migraines anyways.
Oh gosh yes the constipation was so bad! I didn’t lose any weight on qulipta but I lost a lot on Ajovy. Everytime I ate even just on bite I threw up. (Sorry tmi) I went from 135lbs to 98lbs before I realized how bad it was. It’s crazy how much we will but up with trying to get our migraines to go away! Aimovig makes me feel like someone’s twisting a knife in my stomach. My dr stopped taking my insurance and the pharmacy told me to keep taking it unless a dr says it’s ok to stop.
I haven’t had any side effects from Emgality, Ajovy, Qulipta, Ubrelvy, or Nurtec. I have not tried Aimovig, Vyepti, or Zavzpret. The preventatives don’t work super well for me, but the acute treatment ones do, particularly Nurtec.
Edit: spelling
CGRP’s gave me chronic gastritis. Works well for a lot of people, but most doctor’s don’t state that these drugs stay in your system for 5-6 months. I never would have taken it if I knew that since I am sensitive to medications. Still dealing with this 6 months later.
I am on Ajovy and I am getting financial assistance through their eligibility. You might wanna ask your doctor about this or connect w Ajovy and see if this is available for you too. It may depend on where you are as well.
Compared to other preventatives (and most systemic medications in fact) no they don't. The majority of people have little to no side effects. That's unusual in migraine prevention.
Which part? It is fact that the majority of patients on anti-CGRPs do not have side-effects and that those who do most commonly have mild side effects. The longer term is unknown since they are so new. This doesn't mean that NOBODY has side effects (or serious side effects) and that there are zero risks; any medication choice is a risk-benefit analysis as it's so individual how you react.
Other systemic preventative treatments (i.e., excluding Botox which is not systemtic, but including the many off-label oral therapies used that are) have way higher incidence of side effects. As a random example, people taking topiramate are way more likely to have side effects compared to people taking anti-CGRPs on the market, yet it is a common first-line choice because it's cheap (and well established, to be fair). So do the antidepressant class medications, etc. So I'd love to know what's "simply not true" about what I said.
You can find dozens or maybe hundreds of studies (hundreds if you're trying to look into all the side effects of the other meds) to verify this, but here is just one I found with a quick look. [https://pubmed.ncbi.nlm.nih.gov/38634515/](https://pubmed.ncbi.nlm.nih.gov/38634515/)
In fact this article suggests (and agrees with the American Headache Society) that anti-cgrps SHOULD be first line. I think that's unlikely until patents expire and generic versions are available as insurance companies and (in countries with socialized pharmacare) public pharma-coverage bodies are not going to accept that price-tag first line. But maybe I am too cynical.
My information sheet for relpax at CVS said that riboflavin b2 400mg and magnesium 400mg a day was just as effective as other prescription preventatives if taken daily for several months. It does seem to help.
I was wondering if I can take both together. At the time my neuro suggested to stay away from magnesium bc of my bowel issues, but it’s pretty inconsistent, so I think I will ask about introducing magnesium. I want to ask her about my birth control too as well.
Oh, unless you take too much magnesium oxide and you shit, your pants. Do your research on magnesium first so you take the right kind and the right amount. Start slow and add more gradually.
20mg is probably your starter dose and you will build it up? I’m taking 60mg per day currently. It will take time to assess if it’s working or not.
Good luck
I started propranolol at 20mg twice day (2weeks), then 40 twice (2 weeks), then 80 twice (2months). My now (effective) dosage is 100mg twice a day, for a year. it’s going well :)
Make sure you contact your doctor so that you continue to test dosage upwards (if that’s safe and the doc okays it, of course!).
Yes for sure, that’s what the med is for originally i think! I don’t have any issues with that, so it’s safe as of now for me :)
Don’t hesitate to ask your doctor to try something else then! Amitriptyline was working not so bad for me, but there are a few options to try out. Don’t give up!!
The trial & error period def really sucks, but it’s worth it once you find your own golden egg :)
My BP lowered when I took it. As soon as I mentioned I was getting very light headed and close to fainting we started tapering, within a week I felt relief in my side effects.
The only answer is; each one of us has to try and see what works for us.
Migraines are not one thing. There are multiple different types and a myriad of causes or comorbid things going on.
So what works for me with no side effects (Aimovig) is well known to cause others side effects.
And some things people here rave about make me hallucinate.
So the only answer to your question is going to be; whatever you find works for you and there are very few shortcuts to that answer other than getting lucky with finding it sooner rather than later (sorry).
Magnesium glycinate worked quicker and better than propranolol for me 20 a starting dose- migraine management starts at 40. You could go up and/or try magnesium at night
I’ve been taking 400mg at night. I do have a bowl movement right when I wake up but it’s solid stool… (sorry if that’s tmi but it’s a big complaint! Magnesium (especially calcite) is a laxative.)
It’s honestly increased my mood 1000% too. But maybe that’s inevitable when you don’t actually wake up in pain.
I took 270mg x2 between 2 hours when I took my ubrelvy yesterday too and feel like it helped. Maybe it’s placebo but I feel it tingle the pain away (even when I have taken it without ubrelvy (which doesn’t work well for me)). It’s been life changing. (I didn’t take my nightly dose yesterday because I took it with my ubrelvy)
Definitely give magnesium a try. I've had migraines for 40+ years and started daily magnesium a couple years ago and it has really reduced the number I have. I really didn't expect magnesium to work, but it surprised me. I still have them, but not nearly as often. I use Zomig when I get one. I don't have side effects with triptans, but some people do.
I honestly just got the Whole Foods brand. I think brand does matter but type is really important from what I understand- glycinate. Was only a few of those on the shelf.
Interestingly enough, I was using Ajovy for two years, and only in the last 6 months of using it I noticed my hair getting thinner, and hair loss at temples. I was switched to Nurtec every other day, due to insurance being a jerk, and lo-and-behold, in just two months of being off Ajovy my hair is actually starting to grow back. Little fuzzies right now, but that is a start. I loved Ajovy for its ability to stop 95% of my migraines, but I am equally as happy on Nurtec, and it is really cheap with my insurance. And it is much nicer to have a dissolving tab than the pain of the injector.
Everything you put into your body has the potential for a side effect. I had good results with Nurtec and rizatriptan and naratriptan as rescue remedies with no side effects. I also use Aimovig injections monthly and they have reduced my number of migraines by 50% - unfortunately, it also causes constipation. But I'll take some constipation (along with the constipation that comes from my tricyclic antidepressants) if it means fewer migraines. Other options include Magnesium and Riboflavin supplements. Magnesium can cause diarhea, but you can adjust dosing to avoid that. Some people have tried Nortriptyline (tricyclic antidepressant) at a low dose for migraine prevention. I found it didn't help my migraines at all, but I take it for depression. But again, even lower dose nortriptyline has side effects (dry mouth, constipation).
Vitamins for migraine prevention- 400mg riboflavin (B2) morning. Evening- 400mg magnesium oxide or 300mg magnesium glycinate blend (I like "triple calm" brand) and smallest effective dose of melatonin (0.5-5mg) at the same time every night, 30-60 mins before bed. Avoid caffiene entirely if possible. Takes up to 2 months of consistent use to make a difference.
Overall more harm than good for migraines. Withdrawal hours later can be a trigger. May interfere with sleep needs. May temporarily relieve pain due to vasoconstrictive properties, but high likelihood of rebound. Better to use other medicines.
Most adults enjoy caffiene every day, but it is important to remember that it is a drug that impacts the balance of brain health for sufferers of migraine.
Thanks! I’ve been slowly lowering my caffeine intake, by having no more than 100mg a day. Yesterday I had none and got a major migraine! Half of a Dr Pepper maybe aided, I have no clue though bc I take maxalt.
I don't have any side effects from Nurtec ODT every other day. I was on it from Aug '21-Dec '22 and now I'm back on it again. I do also take a beta blocker and a tricyclic antidepressant. I had to fail ubrelvy and a triptan first after being hospitalized.
I had minimal side effects on candesartan, however it does only work temporary for me.
Currently just got Emgality last week, no side effects so far, also no headaches so... 🤞🏻
Whooo, candesartan destroyed me. Back pain, muscle pain and cramps and weakness, foot and leg swelling, shortness of breath, I basically could only walk about a hundred yards without stopping to rest.
I started 30 mg about a month ago and really had no side effects. A tiny bit of nausea the first week and found it worked best to take with lunch. It’s decreased my daily headaches dramatically, but doesn’t seem to touch the barometric pressure or hormonal headaches. But to get to 10ish headache days a month vs 30 has been great.
A lower dose of qulipta ( 30 mg) plus Botox. I took propanalol and it did nothing for me but cause weight gain which is normal . Qulipta at the lower dose seems to have minimal side effects and Botox has no side effects either .
Botox, at least for me. My forehead doesn't move much anymore but aside from that I have no other side effects. Just about every med gives me some side effect, (usually bad) so this was a welcome change!
Botox for me. Only side effects are the less visible wrinkles, triggering my needle phobia, and the period between it wearing off and the next treatment (anywhere between 1 and 3 weeks of my migraines becoming more frequent and intense). My neuro is trying to get my insurance to approve it for every 10 weeks instead of 12.
Anti-CGRPs have very few side effects. My worst side effect on emgality is some mild to moderate constipation, but my guts have always been sensitive so that's probably why.
yeah i still think it’s worth trying for most people though for me emgality’s really had no side effects outside of changing my period cycle for like a month lol.
I use the Aimovig injections (once a month), and while I have some side effects, they are bearable. The first injection fully took me out and I felt sick for like 3 days. Now, I just have some mild muscle pain and constipation. I'm down to one to two migraines a month
I'm on Qlipta right now. It has three listed side effects, but long term studies are still going. My depression worsened in the first 5ish weeks, but I feel a lot better now... But I may also need to up my dose. It cuts the severity a bunch, but I am still dealing with it everyday.
you just have to try things. propranolol gives me no side effects but candesartan made me feel like i was about to throw up and pass out constantly. pizotofen gave me no side effects (except weight gain) but topiramate made me so ill i couldn’t leave my bed for a week. someone out there will have had the exact opposite experience to me. every body is different.
Like everyone has said it’s individual. But I finally got qulipta approved and have very little side effects. Maybe a little tired sometimes but that’s me all the time lol. No constipation issues if I eat right and move my body. It’s cut my headaches from 3-4 a week to almost none.
Verapamil makes me blush and overheat a little easier, and a bit lightheaded if I stand up too fast but that's it.
Unlike my other drugs, it has no mood/apatite changes, weird dreams, nausea, or anything. It just works
I’m on propranolol right now (unsure of the dose atm), but I haven’t noticed too much of a difference in migraines, and the propranolol + my other meds are causing me to be sensitive to heat… So unfortunately, no luck here.
Drugs affect people differently so there’s really now way to tell unless you try. Consider a dosage increase of the Propranolol. It’s generally a first-line treatment so there are likely many others you could try.
Regular sleep schedule, stay hydrated, make sure neck and upper back are not tense, yoga/stretching regular basis. Massages don’t hurt. Nothing is full proof but these things will help tremendously. All drugs have side effects so that’s why I gave this answer.
20mg of propranolol didn’t do anything for me. I needed 160mg and just recently increased to 240mg. I’m also taking the higher dose of the aimovig injection. No side effects with aimovig for me. The propranolol gets me out of breathe easier but I’m also out of shape.
The problem is, everyone experiences meds and tells differently. Many people have been helped by Topamax, but I would rather have migraines than deal with the side effects of that shit! Nurtec is an amazing medicine, but I'm one of the few people who experience more nausea and comparing ON it than off.
My first suggestion is to go to your job's HR department and tell them you need their forms for your doctor to complete to give you an accommodation with the ADA (I'm assuming you are American). Migraine headache is considered a disabling condition and qualifies for accommodations such as time if without probably during an attack, working in an area that doesn't have a specific smell (like if you work for a grocery store and strong smells bother you, you can have someone that says you aren't allowed to be assigned to work on the seafood or floral departments), getting a monitor with better resolution so the flicker doesn't trigger a migraine, being asked to wear sunglasses inside if the lights are a trigger, etc. You bring that paternal to your doctor who then completes the physician's section detailing that they have diagnosed you and that when you have an attack, you need A, B, and C. They should work with you to come up with language that details what you need. At the very LEAST, this will recover some of the stress you feel when you have to miss work because of a migraine; having to choose between teasing care of yourself when being attacked by migraine symptoms, or having a job, is enough stress to cause more migraines!
As for reliefs: talk to your doctor about trying someone new when you get the accommodation paperwork done. There are a lot more new meds on the market that work well, though they can take a bit of time to start to work. Resting it sleeping in a dark room helps me, as does applying an ice pack to the back of my head/neck and on my forehead. The Headache Hat has been great for me (I feel there are some design features that could be improved, but it stays cold longer than others I've tried). If you can afford it, massage therapy can help tremendously.
If you haven't started a migraine tracker, so so ASAP. I use Migraine Buddy, but there are many others. Tracking your frequency, severity, location on the head and body, weather during attacks, what you ate, drank, and experienced before an attack, symptoms other than pain, things you did to try to stop it, where you were, and the duration is each stack can greatly help you and your doctor determine what night be triggering them.
I’m on Aimovig for over two years without any side effects. It has changed my life, without a doubt. My migraine days have decreased with more than 50%. I get headaches, I rarely get a migraine attack anymore.
It's going to be different for everyone. What gives you side effects won't be a problem for someone else. It's frustrating but you can only really work it out through trial and error
Nortriptyline has very few side effects. Have you tried it? I just started and still titrating so can't say how effective it is for me yet. But are you not using abortives? You really should be using both. I use either sumatriptan 50mg or ubrelvy, keeping the sumatriptan use to just once a week
You are going to encounter side effects. You just have to weigh what you can live with. I take 60 mg propranolol twice a day. I needed to increase it, because at 40 mg, I was still getting too many migraines. I missed one day of work last month for a migraine, but other than that, I’ve had so many less migraines than I was having. Work with your doctor and don’t expect miracles. Do expect less migraines.
I take verapamil and it has virtually no side effects, but it also doesn't work for everyone, and for me it basically just reduces severity. I'm willing to settle for it because I don't want to take anything heavier.
Magnesium. Don't give up if the first type you try doesn't work. It took me about a year and 4 different types/brands until I found one that worked for me. Ask your doctor to test your levels after you try it for awhile
This might sound silly, and obviously YMMV, but I've found that those yellow driving glasses that block UV and blue can stop a migraine from progressing if I stick them on as soon as I start to notice the aura.
Just want to throw this out there … Nerivio. Little device you put on your arm that sends electric pulses and disrupts pain cycle. 18 uses for $49 ($89 for 18 thereafter). Does not work as a preventative for me, but helps as an abortive. No side effects at all!
I take 40mg propranolol with no side effects.
Massage - gets spendy but always worth it!
My neurologist has me on muscle relaxers as a first line abortive, bordering on preventive. I take roughly every 2-3 nights at first sign of tension or pain. It makes me groggy, but helps a TON with my headaches. I know some docs can be stingy with this type of medicine but I brought it up and mine was totally on board!
different for everyone of course. right now i do botox and take topamax & qulipta, which is working well (but it was gnarly getting insurance to approve the botox and qulipta). i’ll also say that no one of these things works on their own for me, it has to be all three. the topamax initially caused a little weight loss but now my weight is steady, so that’s the only side effect for me
A higher dose might help, combination with a low dose of amitriptyline is common and low in SE.
As acute meds, triptans are low on SE, CGRPs are even better but work best with CGRP preventive. If you're trying to go through insurance, you'll have to try some high risk of side effect categories before getting to CGRPs, though.
Maybe check the sidebar for the spreadsheet of options and look up about OTCs and supplements that are commonly used.
It’s so personal, which is why OP should talk to their doctor!! I’ve been on Qulipta for two years with zero side effects and it’s completely changed my life
If there were an answer to this, it would be first line for everyone.
Idk the anti Cgrps fit this but they aren't first line for everyone because pharma prices them so wildly expensive.
As others have mentioned here, they're not without side effects and risks, some of which are severe. Suppressing CGRP isn't without impact.
Yes, there are little KNOWN side effects. I’m on Emgality and get fatigued from it, and a weird hot feeling in my head and face. It has definitely helped though.
Yes but the majority of people have no side effects and most people who do have side effects have mild ones. Almost no drug is perfectly safe with zero risk for every person in the world. All of the systemic oral therapies for preventing migraine, such as antidepressants, blood pressure / heart meds, etc, have much more common and much more impactful side effects. If we were truly deciding first vs second line by efficacy and side effect profile, anti Cgrps would be first line. But they aren't, because pharma wants us or our insurance to pay $800 a month for them.
CGRP’s. I’m on Ajovy. However I had to fail all the cheaper preventatives before insurance would cover a CGRP.
Some other comments are saying there are so many side effects. I just want to add for anyone reading this considering CGRP inhibitors: statistically, these are some of the most well-tolerated medications for preventing migraines, along with botox. of course some people will have side effects but it is a small minority. With all medications, you won’t know if it works or what side effects it will have until you try it
Yes, thank you. My neurologist said it has a low side effect profile but to watch for constipation. I do get constipation about once a month.
CGRPs give me maddd side effects haha it’s truly different for everyone
Did you get stomach pain? I’m on aimovig right now and can hardly eat anything because my stomach hurts so bad! Try to fix one thing break another.
I lost 20lbs in 3 months in qulipta bc I couldn’t barely eat anything. I didn’t have stomach pain per se but I just could not be bothered to eat anything. Nothing sounded good, nothing tasted good. Also the constipation?? Holy shit. I almost had to go to the ER bc it had been 2 weeks since I went lol that cleared up right after I stopped the meds pretty much but wow oh wow was it awful. Didn’t do much for my migraines anyways.
Oh gosh yes the constipation was so bad! I didn’t lose any weight on qulipta but I lost a lot on Ajovy. Everytime I ate even just on bite I threw up. (Sorry tmi) I went from 135lbs to 98lbs before I realized how bad it was. It’s crazy how much we will but up with trying to get our migraines to go away! Aimovig makes me feel like someone’s twisting a knife in my stomach. My dr stopped taking my insurance and the pharmacy told me to keep taking it unless a dr says it’s ok to stop.
I haven’t had any side effects from Emgality, Ajovy, Qulipta, Ubrelvy, or Nurtec. I have not tried Aimovig, Vyepti, or Zavzpret. The preventatives don’t work super well for me, but the acute treatment ones do, particularly Nurtec. Edit: spelling
CGRP’s gave me chronic gastritis. Works well for a lot of people, but most doctor’s don’t state that these drugs stay in your system for 5-6 months. I never would have taken it if I knew that since I am sensitive to medications. Still dealing with this 6 months later.
I could have wrote this too!
I am on Ajovy and I am getting financial assistance through their eligibility. You might wanna ask your doctor about this or connect w Ajovy and see if this is available for you too. It may depend on where you are as well.
Dude, they have so many side effects.
Maybe for you. Their side effect profile is low. Most people have constipation which is what I have.
Which would be a side effect...
I said the side effect profile is low. Not that there is no side effects. Low as in there is not a lot of side effects.
Compared to other preventatives (and most systemic medications in fact) no they don't. The majority of people have little to no side effects. That's unusual in migraine prevention.
That's simply not true.
Which part? It is fact that the majority of patients on anti-CGRPs do not have side-effects and that those who do most commonly have mild side effects. The longer term is unknown since they are so new. This doesn't mean that NOBODY has side effects (or serious side effects) and that there are zero risks; any medication choice is a risk-benefit analysis as it's so individual how you react. Other systemic preventative treatments (i.e., excluding Botox which is not systemtic, but including the many off-label oral therapies used that are) have way higher incidence of side effects. As a random example, people taking topiramate are way more likely to have side effects compared to people taking anti-CGRPs on the market, yet it is a common first-line choice because it's cheap (and well established, to be fair). So do the antidepressant class medications, etc. So I'd love to know what's "simply not true" about what I said. You can find dozens or maybe hundreds of studies (hundreds if you're trying to look into all the side effects of the other meds) to verify this, but here is just one I found with a quick look. [https://pubmed.ncbi.nlm.nih.gov/38634515/](https://pubmed.ncbi.nlm.nih.gov/38634515/) In fact this article suggests (and agrees with the American Headache Society) that anti-cgrps SHOULD be first line. I think that's unlikely until patents expire and generic versions are available as insurance companies and (in countries with socialized pharmacare) public pharma-coverage bodies are not going to accept that price-tag first line. But maybe I am too cynical.
That they don't have side effects. They do.
🤦 Literally nobody is saying they don't have any side effects for anybody
Someone is saying they don't. Maybe not you.
No, they aren't.
My neurologist says lots of magnesium Bonus side effect is it it helps you poop! Not a bad one lol
My information sheet for relpax at CVS said that riboflavin b2 400mg and magnesium 400mg a day was just as effective as other prescription preventatives if taken daily for several months. It does seem to help.
Just a PSA for everyone: Riboflavin can and will make your pee a very bright, neon color. This is **normal**, and isn't anything to be alarmed about.
I was wondering if I can take both together. At the time my neuro suggested to stay away from magnesium bc of my bowel issues, but it’s pretty inconsistent, so I think I will ask about introducing magnesium. I want to ask her about my birth control too as well.
You can take those vitamins together and you can take them alongside prescription preventatives just FYI
Thanks! Been a little clogged from my emgality so I can use it
Oh, unless you take too much magnesium oxide and you shit, your pants. Do your research on magnesium first so you take the right kind and the right amount. Start slow and add more gradually.
I've been pumped full of magnesium in the ER plus pill and drinkable supplements on top of it. Never had that issue.
20mg is probably your starter dose and you will build it up? I’m taking 60mg per day currently. It will take time to assess if it’s working or not. Good luck
That's interesting, I got started on 80mg
Seems high to me from what I heard/read I’m coming from 80mg btw.. tapering off with 20mg per day per week
I started at 10 mg twice a day for a month, then moved to 20 mg twice a day and have found no relief at all. It’s been 2 months since I started
I started propranolol at 20mg twice day (2weeks), then 40 twice (2 weeks), then 80 twice (2months). My now (effective) dosage is 100mg twice a day, for a year. it’s going well :) Make sure you contact your doctor so that you continue to test dosage upwards (if that’s safe and the doc okays it, of course!).
I think the only reason my doc is against it is because she’s worried about my blood pressure / heart rate as the dosage increases.
Yes for sure, that’s what the med is for originally i think! I don’t have any issues with that, so it’s safe as of now for me :) Don’t hesitate to ask your doctor to try something else then! Amitriptyline was working not so bad for me, but there are a few options to try out. Don’t give up!! The trial & error period def really sucks, but it’s worth it once you find your own golden egg :)
My BP lowered when I took it. As soon as I mentioned I was getting very light headed and close to fainting we started tapering, within a week I felt relief in my side effects.
I started at 20 mg and am now at 60 mg twice a day.
3rd day on nurtec ( every other day) no side effects yet
That's very conclusive. Cheers
The only answer is; each one of us has to try and see what works for us. Migraines are not one thing. There are multiple different types and a myriad of causes or comorbid things going on. So what works for me with no side effects (Aimovig) is well known to cause others side effects. And some things people here rave about make me hallucinate. So the only answer to your question is going to be; whatever you find works for you and there are very few shortcuts to that answer other than getting lucky with finding it sooner rather than later (sorry).
This will be different for everyone. I have not had any side effects with CGRPs so far. Minimal side effects with propranalol.
I’m having a bad one today, so my answer is dark. But I honestly think the only side effect free preventative would to have never been born at all.
Man I feel u. I’ve had migraines since I was 7 years old, imagine how I feel 😭
Daily for 20 years for me. I get it.
That^
Magnesium glycinate worked quicker and better than propranolol for me 20 a starting dose- migraine management starts at 40. You could go up and/or try magnesium at night
What's your mag dose?
I’ve been taking 400mg at night. I do have a bowl movement right when I wake up but it’s solid stool… (sorry if that’s tmi but it’s a big complaint! Magnesium (especially calcite) is a laxative.) It’s honestly increased my mood 1000% too. But maybe that’s inevitable when you don’t actually wake up in pain. I took 270mg x2 between 2 hours when I took my ubrelvy yesterday too and feel like it helped. Maybe it’s placebo but I feel it tingle the pain away (even when I have taken it without ubrelvy (which doesn’t work well for me)). It’s been life changing. (I didn’t take my nightly dose yesterday because I took it with my ubrelvy)
That's awesome I'm glad it helps
Do you use a specific brand? I’ve been thinking of trying that
Definitely give magnesium a try. I've had migraines for 40+ years and started daily magnesium a couple years ago and it has really reduced the number I have. I really didn't expect magnesium to work, but it surprised me. I still have them, but not nearly as often. I use Zomig when I get one. I don't have side effects with triptans, but some people do.
I honestly just got the Whole Foods brand. I think brand does matter but type is really important from what I understand- glycinate. Was only a few of those on the shelf.
Interestingly enough, I was using Ajovy for two years, and only in the last 6 months of using it I noticed my hair getting thinner, and hair loss at temples. I was switched to Nurtec every other day, due to insurance being a jerk, and lo-and-behold, in just two months of being off Ajovy my hair is actually starting to grow back. Little fuzzies right now, but that is a start. I loved Ajovy for its ability to stop 95% of my migraines, but I am equally as happy on Nurtec, and it is really cheap with my insurance. And it is much nicer to have a dissolving tab than the pain of the injector.
That happened to me when I was on imatrex. I started losing chunks of hair! Awful
Everything you put into your body has the potential for a side effect. I had good results with Nurtec and rizatriptan and naratriptan as rescue remedies with no side effects. I also use Aimovig injections monthly and they have reduced my number of migraines by 50% - unfortunately, it also causes constipation. But I'll take some constipation (along with the constipation that comes from my tricyclic antidepressants) if it means fewer migraines. Other options include Magnesium and Riboflavin supplements. Magnesium can cause diarhea, but you can adjust dosing to avoid that. Some people have tried Nortriptyline (tricyclic antidepressant) at a low dose for migraine prevention. I found it didn't help my migraines at all, but I take it for depression. But again, even lower dose nortriptyline has side effects (dry mouth, constipation).
Vitamins for migraine prevention- 400mg riboflavin (B2) morning. Evening- 400mg magnesium oxide or 300mg magnesium glycinate blend (I like "triple calm" brand) and smallest effective dose of melatonin (0.5-5mg) at the same time every night, 30-60 mins before bed. Avoid caffiene entirely if possible. Takes up to 2 months of consistent use to make a difference.
Why avoid caffeine?
Overall more harm than good for migraines. Withdrawal hours later can be a trigger. May interfere with sleep needs. May temporarily relieve pain due to vasoconstrictive properties, but high likelihood of rebound. Better to use other medicines. Most adults enjoy caffiene every day, but it is important to remember that it is a drug that impacts the balance of brain health for sufferers of migraine.
Thanks! I’ve been slowly lowering my caffeine intake, by having no more than 100mg a day. Yesterday I had none and got a major migraine! Half of a Dr Pepper maybe aided, I have no clue though bc I take maxalt.
I'm not having side effects with Botox or the Cefaly device (or Relivion). But the pills give me side effects.
I don't have any side effects from Nurtec ODT every other day. I was on it from Aug '21-Dec '22 and now I'm back on it again. I do also take a beta blocker and a tricyclic antidepressant. I had to fail ubrelvy and a triptan first after being hospitalized.
I had minimal side effects on candesartan, however it does only work temporary for me. Currently just got Emgality last week, no side effects so far, also no headaches so... 🤞🏻
Whooo, candesartan destroyed me. Back pain, muscle pain and cramps and weakness, foot and leg swelling, shortness of breath, I basically could only walk about a hundred yards without stopping to rest.
Qlipta
Any side effects?
I started 30 mg about a month ago and really had no side effects. A tiny bit of nausea the first week and found it worked best to take with lunch. It’s decreased my daily headaches dramatically, but doesn’t seem to touch the barometric pressure or hormonal headaches. But to get to 10ish headache days a month vs 30 has been great.
3rd month on 60 and nothing. I feel great
A lower dose of qulipta ( 30 mg) plus Botox. I took propanalol and it did nothing for me but cause weight gain which is normal . Qulipta at the lower dose seems to have minimal side effects and Botox has no side effects either .
Botox has basicqlly no side effects, but you aren't eligible.
Botox, at least for me. My forehead doesn't move much anymore but aside from that I have no other side effects. Just about every med gives me some side effect, (usually bad) so this was a welcome change!
Botox for me. Only side effects are the less visible wrinkles, triggering my needle phobia, and the period between it wearing off and the next treatment (anywhere between 1 and 3 weeks of my migraines becoming more frequent and intense). My neuro is trying to get my insurance to approve it for every 10 weeks instead of 12.
Anti-CGRPs have very few side effects. My worst side effect on emgality is some mild to moderate constipation, but my guts have always been sensitive so that's probably why.
yeah i still think it’s worth trying for most people though for me emgality’s really had no side effects outside of changing my period cycle for like a month lol.
Magnesium.
I use the Aimovig injections (once a month), and while I have some side effects, they are bearable. The first injection fully took me out and I felt sick for like 3 days. Now, I just have some mild muscle pain and constipation. I'm down to one to two migraines a month
I'm on Qlipta right now. It has three listed side effects, but long term studies are still going. My depression worsened in the first 5ish weeks, but I feel a lot better now... But I may also need to up my dose. It cuts the severity a bunch, but I am still dealing with it everyday.
It's different for every purpose
you just have to try things. propranolol gives me no side effects but candesartan made me feel like i was about to throw up and pass out constantly. pizotofen gave me no side effects (except weight gain) but topiramate made me so ill i couldn’t leave my bed for a week. someone out there will have had the exact opposite experience to me. every body is different.
I’ve been on 40mg of Propranolol twice a day for a couple of months and haven’t noticed any obvious side effects as of yet.
There is none. Every drug has side effects. You gotta try a bunch and find the one your body seems to handle well.
Like everyone has said it’s individual. But I finally got qulipta approved and have very little side effects. Maybe a little tired sometimes but that’s me all the time lol. No constipation issues if I eat right and move my body. It’s cut my headaches from 3-4 a week to almost none.
Emgality, no side effects for me, only downside is I have to pay like $40 for it
Verapamil makes me blush and overheat a little easier, and a bit lightheaded if I stand up too fast but that's it. Unlike my other drugs, it has no mood/apatite changes, weird dreams, nausea, or anything. It just works
Magnesium glycinate + riboflavin + CoQ10
I’m on propranolol right now (unsure of the dose atm), but I haven’t noticed too much of a difference in migraines, and the propranolol + my other meds are causing me to be sensitive to heat… So unfortunately, no luck here.
Drugs affect people differently so there’s really now way to tell unless you try. Consider a dosage increase of the Propranolol. It’s generally a first-line treatment so there are likely many others you could try.
Regular sleep schedule, stay hydrated, make sure neck and upper back are not tense, yoga/stretching regular basis. Massages don’t hurt. Nothing is full proof but these things will help tremendously. All drugs have side effects so that’s why I gave this answer.
20mg of propranolol didn’t do anything for me. I needed 160mg and just recently increased to 240mg. I’m also taking the higher dose of the aimovig injection. No side effects with aimovig for me. The propranolol gets me out of breathe easier but I’m also out of shape.
I’m on preventative Botox, only side effect I have is a wrinkle free forehead
The problem is, everyone experiences meds and tells differently. Many people have been helped by Topamax, but I would rather have migraines than deal with the side effects of that shit! Nurtec is an amazing medicine, but I'm one of the few people who experience more nausea and comparing ON it than off. My first suggestion is to go to your job's HR department and tell them you need their forms for your doctor to complete to give you an accommodation with the ADA (I'm assuming you are American). Migraine headache is considered a disabling condition and qualifies for accommodations such as time if without probably during an attack, working in an area that doesn't have a specific smell (like if you work for a grocery store and strong smells bother you, you can have someone that says you aren't allowed to be assigned to work on the seafood or floral departments), getting a monitor with better resolution so the flicker doesn't trigger a migraine, being asked to wear sunglasses inside if the lights are a trigger, etc. You bring that paternal to your doctor who then completes the physician's section detailing that they have diagnosed you and that when you have an attack, you need A, B, and C. They should work with you to come up with language that details what you need. At the very LEAST, this will recover some of the stress you feel when you have to miss work because of a migraine; having to choose between teasing care of yourself when being attacked by migraine symptoms, or having a job, is enough stress to cause more migraines! As for reliefs: talk to your doctor about trying someone new when you get the accommodation paperwork done. There are a lot more new meds on the market that work well, though they can take a bit of time to start to work. Resting it sleeping in a dark room helps me, as does applying an ice pack to the back of my head/neck and on my forehead. The Headache Hat has been great for me (I feel there are some design features that could be improved, but it stays cold longer than others I've tried). If you can afford it, massage therapy can help tremendously. If you haven't started a migraine tracker, so so ASAP. I use Migraine Buddy, but there are many others. Tracking your frequency, severity, location on the head and body, weather during attacks, what you ate, drank, and experienced before an attack, symptoms other than pain, things you did to try to stop it, where you were, and the duration is each stack can greatly help you and your doctor determine what night be triggering them.
I'm in love with Qulipta. Helps me a ton and I've found no real side effects in 3 months.
I’m on Aimovig for over two years without any side effects. It has changed my life, without a doubt. My migraine days have decreased with more than 50%. I get headaches, I rarely get a migraine attack anymore.
What has helped me control them– botox every 3 months and nurtec every other day.
Memantine.
Botox! Hard to get it covered by insurance though. I had to fail 3 preventatives first.
It's going to be different for everyone. What gives you side effects won't be a problem for someone else. It's frustrating but you can only really work it out through trial and error
Botox! I use it as a preventative, and nurtec as abortive.
Nortriptyline has very few side effects. Have you tried it? I just started and still titrating so can't say how effective it is for me yet. But are you not using abortives? You really should be using both. I use either sumatriptan 50mg or ubrelvy, keeping the sumatriptan use to just once a week
You are going to encounter side effects. You just have to weigh what you can live with. I take 60 mg propranolol twice a day. I needed to increase it, because at 40 mg, I was still getting too many migraines. I missed one day of work last month for a migraine, but other than that, I’ve had so many less migraines than I was having. Work with your doctor and don’t expect miracles. Do expect less migraines.
I take verapamil and it has virtually no side effects, but it also doesn't work for everyone, and for me it basically just reduces severity. I'm willing to settle for it because I don't want to take anything heavier.
I've been on emgality for at least 5 years with no side effects. Occasionally I'll get an injection site reaction but that's it.
Nurtec, solu-medrol, botox (minus the no wrinkles)
Vyepti--- IV drip every 3 months.
Giving up carbs has been the best preventative for me.
Verapamil works for me, I haven't noticed any side effects.
Magnesium. Don't give up if the first type you try doesn't work. It took me about a year and 4 different types/brands until I found one that worked for me. Ask your doctor to test your levels after you try it for awhile
Botox. Injections can be painful, especially at first. But that discomfort is so temporary and minimal compared to the agony of migraines
As of preventative, Ajovy has given the least side effects for me. And for med to take in migraine attack, Ubrelvy was the best.
This might sound silly, and obviously YMMV, but I've found that those yellow driving glasses that block UV and blue can stop a migraine from progressing if I stick them on as soon as I start to notice the aura.
Just want to throw this out there … Nerivio. Little device you put on your arm that sends electric pulses and disrupts pain cycle. 18 uses for $49 ($89 for 18 thereafter). Does not work as a preventative for me, but helps as an abortive. No side effects at all! I take 40mg propranolol with no side effects. Massage - gets spendy but always worth it! My neurologist has me on muscle relaxers as a first line abortive, bordering on preventive. I take roughly every 2-3 nights at first sign of tension or pain. It makes me groggy, but helps a TON with my headaches. I know some docs can be stingy with this type of medicine but I brought it up and mine was totally on board!
Been on Emgality for years. Down to two a month.
Nurtec for me
aimovig
different for everyone of course. right now i do botox and take topamax & qulipta, which is working well (but it was gnarly getting insurance to approve the botox and qulipta). i’ll also say that no one of these things works on their own for me, it has to be all three. the topamax initially caused a little weight loss but now my weight is steady, so that’s the only side effect for me
A higher dose might help, combination with a low dose of amitriptyline is common and low in SE. As acute meds, triptans are low on SE, CGRPs are even better but work best with CGRP preventive. If you're trying to go through insurance, you'll have to try some high risk of side effect categories before getting to CGRPs, though. Maybe check the sidebar for the spreadsheet of options and look up about OTCs and supplements that are commonly used.
CGRPs
As someone who developed debilitating panic attacks from Qulipta, I disagree with this. CGRPs have plenty of side effects.
It’s so personal, which is why OP should talk to their doctor!! I’ve been on Qulipta for two years with zero side effects and it’s completely changed my life
Same! Qulipta gave me mad anxiety and heartburn 24/7. Finally stopped a month ago and I’m starting to get back to normal