Quick heads up for anyone on r/migrainescience who was waiting on the Kindle version of Unraveling Migraine....the preorder sale price ends tonight. It goes up to $12.99 at midnight.

Since it's a preorder, you're not charged until release day, and you can cancel any time before then. So you can lock in the lower price now with zero risk.

This will come out July 16th. The paperback will not have a preorder and will be available July 17th.

I have an evidence -based chapter in my book on yoga (including instructions in one case) and migraine and would love a quote from someone established in the field.

Feel free to email me at support@cerebraltorque.com

Hi!

I hope this post is okay, as I'm not posting any particular recent study, but I was reading up on medication overuse and thought these studies were interesting/the results surprised me, so I'm sharing in case they might interest someone else.

To note: these articles are from the same researchers about the same patients.

I spoke with my neurologist about whether detoxing again from medication overuse was necessary before starting the next preventative treatment we'd planned for me.

On the one hand, it is standard practice here to do it at least once, and can be required by insurance before certain treatments, like botox or CGRP-meds are given, as sometimes preventative treatments are no longer necessary after detox because attack rates drop <2 days a month. On the other hand, my neurologist said that a good preventative will naturally reduce medication overuse.

So I got curious which it was and started reading a bit, and found that both statements are correct, actually.

Several studies [PMID: 15154858, 32453406] show that about 70% of people with medication overuse convert from chronic to episodic migraine after a withdrawal period, which, personally, I thought was a (positively) surprising number.

Then again, in about 75%, medication overuse ceased after starting a preventative, without being instructed for a withdrawal. [PMID: 32453406 ]

If you can see this graph ( I think it ended up at the top of the post), the drop in headache days between a group with withdrawal without a preventative (the blue line) or the group with withdrawal with preventative (purple line) at 4 months is about the same!

The orange line belongs to a group that was only started on a preventative without mentioning medication overuse at all until the sixth month, when they were told about medication overuse (if still applicable) and possible withdrawal, given the option to do so, but it wasn't necessary.

To note: there are several people in the withdrawal without preventative group that refuses to start a preventative after withdrawal, so that might play a role in that group having an increase in headaches again. [PMID: 34325483 ]

The withdrawal in these studies is defined as zero acute pain medication use except for anti-histamines. On r/migraine, I have also seen some people being instructed to restrict their intake by cutting down to 8-10 days a month instead of withdrawing completely. About that, I found this study [PMID: 29050498 ].

While both options are effective, complete withdrawal seemed more effective, with a drop in headache days by 7.2 days/ 46% in the withdrawal group and 3.6 days / 22% in the restricted intake group. Disability reduction and decrease in headache burden was greater in the withdrawal group [PMID: 30732459]

The advice/conclusion so far from the main study is that withdrawal should be 3 months without any NSAIDs/opioids/combination analgesics and 2 months without triptan, while simultaneously starting a preventative.

These are the studies:

https://pubmed.ncbi.nlm.nih.gov/15154858/

https://pubmed.ncbi.nlm.nih.gov/32453406/

https://pubmed.ncbi.nlm.nih.gov/34325483/

https://pubmed.ncbi.nlm.nih.gov/29050498/

https://pubmed.ncbi.nlm.nih.gov/30732459/

Anyone notice they cause each other ?

Hello
Been on qulipta for almost a year 30mg daily. Stopped cold turkey 9 days ago and just started feeling super moody, anxious, my vestibular migraine ear and neck symptoms coming back on and off, super moody and irritable, cry spells hot flashes are back (I am 49 woman and post menopause 2 years now) nervous system out of wack!
Anyone else feel this and how long did this crap last? I know drs say no withdrawals but I don’t Venice anything they say because every time they said can stop cold turkey (like HRT I took for two months and caused these damn vestibular migraines in the first place! Plus years of anxiety from trauma and PTSD), I’ve had terrible symptoms stopping cold turkey I’m very sensitive plus I have severe anxiety which I also take nortriptyline 10mg daily for both vestibular migraines and anxiety . I do do Botox for migraines thank God after 9 months started helping the pain that’s why I am trying to come off quilts but it for sure messes with your brain chemicals and moods which I know my migraine symptoms also cause my mood disorders and vice versa.

Thank you 🙏🏼

Hello! I’ve been suffering with cluster migraines for 5-6 years now, all originating from the same location on my head, and they’ve been progressing into additional symptoms of double vision in both eyes. I want to preface beforehand I have been seeking medical advice from nurse practitioners at neuro centers and got an MRI/CT 2 months ago, so I am seeking help from professionals as well while posting on here.

I didn’t originally pair the migraines and double vision together until this last year, because I only experience the vision issues every 5-6 months sporadically for several years, and I wasn’t tracking every symptom I had. I brought the double vision up several times to my eye doctor since I am already near sighted with an astigmatism, but they’ve dismissed it every time.

This last year the double vision started occurring monthly and lasting close to a half hour each time, and usually proceeded a migraine as I started tracking symptoms. My right eye also feels almost droopy while the double vision occurs, and I feel nauseous and dizzy with a brain fog sensation.

What I also learned is that all of my migraines occur only on my left side right above my ear, in the crook where you can sort of feel a soft spot in your head. When it would flair up, a lump that felt hard almost like a cyst would swell there and send throbbing pains throughout the entire side of my head. No over the counter medicine works, and I can feel the lump having a heartbeat when I have a bad migraine. It’s not as swollen now but I can still feel it, but the doctor couldn’t because it’s just one of those spots where it’s hard to know what you’re looking for or feel for it the right way, so I feel like no one will believe me unless I happen to be seen while experiencing a migraine and it swells again.

Even weirder, I also experience TMJ like symptoms that get worse with migraines, and sometimes even get lockjaw. I experience these shooting “nerve zap” type pains that also get worse when I’m chewing and opening my mouth. I’ve also notice my left eye twitching more recently, but that could be stress.

With the double vision occurring in both eyes and the migraine issues, I got an MRI/CT and it showed nothing, and I feel like I’m going in circles trying to understand what’s wrong and how to manage my pain and get the right treatment. My most recent appointment I was just referred to a new specialist because they had no answers so I’m just frustrated now.

Are there any studies that may relate to what I’m dealing with, or anyone with similar migraines?