I’ve had both since I was a kid – they run in my family. There was a long period when I was in middle and high school when they disappeared. They were gone so long that I actually forgot I had a history.
Fast forward to the year after my high school graduation. I was on a vacation in Florida and started experiencing excruciating headaches before, during, and after sexual activity. What a way to ruin a vacation, right?
One night it was so bad that I made my girlfriend at the time race me to a local Walgreens and I grabbed anything on the shelf that looked like it could work. I ended up buying some Excedrin Migraine and a spray bottle of homeopathic liquid that was to be applied sublingually (under the tongue) a few times a day for relief. I can’t, for the life of me, remember the name of it, or what was in it.
Interesting side note on the Excedrin Migraine: back when I bought it, it was about double the price of regular Excedrin, and triple the price of “generic” Excedrin. This was before I “grew up” and learned to read labels (plus at the time I honestly wasn’t in the mood to even consider a label read). But about those labels.. turns out Excedrin Migraine had the exact same ingredients and dosages as regular Excedrin. The only difference was in packaging. I did some research on how this could be possible and found out that anytime an over-the-counter medication wants to be on the drugstore shelf, it must go through FDA approval and the FDA requires specific indications before it will be given the rubber stamp. So when Excedrin was first approved for sale, it wasn’t indicated specifically for migraine headaches – it was just for headaches, in general. So when Excedrin wanted to have separately branded products for Tension Headaches and a Migraine “formula”, it had to go through the FDA approval process all over again. The costs incurred in that product’s more recent process is what Excedrin will tell you resulted in a price difference between items. The bottom line? Read the label.
Being uninsured I didn’t want to make a trip to the emergency room or an urgent care center, so I waited until I returned home for some actual doctor’s care. I went in for an office visit and the doctor immediately diagnosed my symptoms as migraine and said oftentimes they will be triggered by sexual activity because blood flow increases during arousal and an increase in blood pressure is a frequent part of the migraine process. He prescribed Midrin, which has since gone through several name changes and may be found at different pharmacies under several other brands such as Epidrin, Migrin-A, and Duradrin. The web site www.midrin.org actually has some decent info on the drug. It’s basically an Excedrin-like cocktail, only with stronger ingredients. Excedrin has Tylenol in it, which we know raises the body’s ability to tolerate pain; aspirin which helps with the inflammation that happens during both migraine and tension headaches; and caffeine which acts as a vasoconstrictor (meaning it tightens the veins so less blood flow and pain messages can get through during a headache). Midrin, on the other hand, has Tylenol; Isometheptene Mucate USP, which is a vasoconstrictor; and Dichioraiphenazone, which is a mild sedative to put you at ease during the stressful bout of your vascular or tension headache.
There was a period of time when Midrin wasn’t available under any brand – deemed the great Midrin shortage. During that time I briefly used Fioricet. It didn’t work as well for me on the headache itself, but left me so loopy that oftentimes I didn’t care. Fioricet has the same cocktail as Midrin or Excedrin – Acetaminophen or Tylenol; Caffeine; and then something called Butalbital, which is a barbiturate and acts more like a muscle relaxant than the mild sedative in Midrin. It is also available with Codeine.
He also prescribed Imitrex for times when the Midrin wasn’t “enough”. Imitrex is in a class of medications called selective serotonin receptor agonists. It works in a different way, but also ends up narrowing blood vessels in the head and stopping debilitating pain signals from being sent to the brain. I’ve since switched from Imitrex to Maxalt melts, or Maxalt-MLT; which is a newer form of the same type of drug. It’s a rapidly-disintegrating pill that you put on your tongue and it’s absorbed through your mouth’s mucus membranes. I find that it definitely acts faster. But it will leave you with some strange-feeling jaw tightness and body tingling, and will likely knock you out – a blessing for night-time migraines, a curse for on-the-job attacks.
In times where my prescriptions weren’t handy or I couldn’t afford them, I would fall back to 1000mg Tylenol, 800mg Ibuprofen, and a can of Diet Coke or Pepsi (caffeinated).. every 6-8 hours.
UPDATE: I have been more headache-free than ever lately. Turns out I have high blood pressure. I never knew this because my recent doctor failed to check my blood pressure when I went in for office visits. I landed in the hospital (a story in itself for another post) and eventually went on a regimen of meds to lower my blood pressure, along with diet changes and some supplements. As stated above, higher blood pressure can trigger headaches of all types, so clearing up the blood pressure issue helped me greatly. Of course when I was initially diagnosed with migraine I didn’t have high blood pressure. Anyway, I’ve also been diagnosed with anxiety and OCD. The anti-anxiety and anti-depressants I’m taking have also seemed to help with the migraines. I still get a tension headache from stress every once in awhile, and a migraine will occasionally pop up, too, but overall things are a lot better. I’ll surely blog later about my high blood pressure, anxiety, and OCD challenges and some of the unique combination therapies I’ve discovered to help me.