My doctor prescribed Midrin for chronic H/A and Migraines

exnursie · Jan 28, 2010

Not to be insulting here, but I found this easly when googled, and I would not advise taking this,. I can guarentee that if you that no doctor with addiction experience would have prescribed this to you.

Being an MD holds no safety for recovery, and I have seen too many nurses fall into the idea that they are ok taking meds when a doctor prescribes it. I really don't know why they seem to have problems looking up these meds and seeing they are taking a drug that is habit forming and not the best thing for maintaining recovery. It is also not something that the BON will like especially if taking for too long.. In fact, it could be something that they see as noncompliance, since this is not a new condition and you agreed to be drug free.

I have not ever had a migraine, altho I have frequent headaches, less since menopause. but aren't there other options for you??

http://www.webmd.com/drugs/drug-6603-MIDRIN+Oral.aspx?drugid=6603&drugname=MIDRIN+Oral&source=0

Do not take more than 8 capsules in a 24-hour period.

This medication may cause withdrawal reactions, especially if it has been used regularly for a long time (longer than 2 weeks) or in high doses. In such cases, withdrawal symptoms (such as mental/mood changes, shaking, seizures) may occur if you suddenly stop using this medication. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately. Though it is very unlikely to occur, this medication can also result in abnormal drug-seeking behavior (addiction/habit forming). Do not increase your dose, take it more frequently, or use it for a longer time than prescribed. Properly stop the medication when so directed. This will lessen the chances of becoming addicted.

LilRedRN1973 · Jan 28, 2010

My doctor does have a history with addiction (this is why I dumped my other doctor who I was getting my narcotics from and found him). He did say that although it has a mild sedative in it, there wasn't strong evidence of it being abused. He counseled me to use it sparingly and only when the Excedrin Migraine did not work or my headaches were incapaciting. He also requested that I discuss it with my LADC prior to taking it. I've spoken in length about it with my Addictionist/LADC when it was first prescribed and we agreed that I would have my husband hang onto it and set up a written "plan of action" for when I feel my headaches are severe enough to need it. It was given to me in November and I've used it once when my headache was severe enough to cause vomiting.

As far as thinking a med is okay because a doctor prescribes it, I have extensive personal experience with this. In fact, my addiction was to my pain medication that I rationalized was okay to take because it was prescribed. I have NO problems looking things up and found similar information that you posted. Many meds cause withdrawal symptoms that are not addicting (Effexor particularly comes to mind) so that's not a qualifier. What I was looking for was someone that had maybe more personal experience\knowledge with this particular medication. My migraines can be mild or incapacitating. As for taking anything else, I've tried all the OTC remedies and usually Excedrin migraine can handle the mild to moderate ones. I've tried cutting cheese, chocolate, etc. out of my diet and keeping a journal to see if any one food precipitates the migraines. I haven't found any that do.

Thank you, though, for your concern. I do understand that just because a physician prescribes something, does not mean it's safe to take. Especially with my history of addiction. This is why I thought I would inquire here to see if anyone else had been through something similar or if someone had experience with this medication.

exnursie · Jan 28, 2010

http://www.aafp.org/afp/2003/1115/p1971.html

LilRedRN1973 · Jan 28, 2010

I'm guessing you posted that because of the section they have on alternatives for treatment......so the only option it gave for migraines was Triptans, which my doctor tried. If anyone else out there has any suggestions on how to deal with migraines, I would like to hear from them. I've tried accupressure, which does work about half the time (it's how I've managed to deal with the 3 migraines I've had this month!), reducing stimulation (retreating to my dark, quiet bedroom), guided imagery, relaxation CD's, etc. As I mentioned before, I've been dealing with these for about 23 years. I was really hopeful when he gave me the Imitrex and the Treximet but with the reaction I had, I don't have hope I will ever try these again. I can't begin to explain how horrible I felt and would rather deal with an excruciating headache than take either one again.

Had I found myself feeling "altered" or sedated, etc. when I took the Midrin, I would have immediately called my doctor and told him I couldn't take it. Early in recovery, I was given several different anti-depressants and quit almost immediately when they made me feel energized and "high" (Wellbutrin and Effexor). I'm very cautious when it comes to meds and almost didn't take the valium for my MRI. After lengthy conversations with my nurse support group, my Aftercare, and my LADC, I realized that motives for taking the valiums were honest ones. I have horrible claustrophia and cannot be in small spaces, let alone an MRI machine with a box over my head. I'm eternally grateful to everyone in my support groups, etc. who advised me to take the valium because once I got into the damn machine, it was horrible. I was able to stay still the 30 minutes for the procedure but was ever so thankful when it was over! (And yes, I tried to find an open air MRI to have my test; there were none at the facilities covered by my insurance). I'm not taking this thing lightly or thinking I can pop a pill to fix what ails me. When I took the dose of Midrin that I did, I had not been able to leave the dark bedroom without becoming nauseous and ended up vomiting. I hadn't been able to eat or even move with getting sick to my stomach. I had taken quite a few doses of Excedrin without any effect. I put off taking the Midrin until the pain was unbearable (and yes, I've had to reevaluate my pain scale because when I was addicted to my pain meds, everything was a 10/10 and warranted a handful of vicodin). My husband asked if I wanted to try the Midrin, I said yes and took 2 pills. My headache was down to about a 3/10 within 30-40 minutes and I was able to get up out of bed.

I understand you are trying to be helpful and working around recovering addicts and alcoholics all day long who consider themselves clean and sober when they are taking ativan, xanax, klonopin, ambien, etc., I get it. I realize how little it would take for me to return to my addiction. But I also cannot continue dealing with some of the headaches I get. If I have one that rates about a 5/10, I deal with it and go on with my day. I suffer from headaches almost daily so I'm quite used to living with a certain level of uncomfortableness. The ones that are almost unbearable take a toll on my life. I'm unable to get out of bed, sometimes for several days, have missed work on more than one occasion, and it's can be very depressing.

I am VERY open to suggestions on other ways to deal with migraines that don't involve medications. I enjoy being med free after the years of taking anti-depressants, abusing the meds for my RA, and being put on various anti-psychotics and mood stabilizers (I was dx'ed bipolar when it was really addiction....now that I've been sober, I no longer have the wild mood swings and all the issues that came with the substance abuse). I would rather not have to take any meds and don't really like having to take the propanolol but it has helped cut down on the frequency, intensity, and duration of the headaches I DO get. I've changed up my diet quite a bit to help with my RA so that is no longer a daily struggle so I know there are other ways to manage pain besides meds. I am hoping this post does not come across as nasty or defensive as that is not my intention and I know online, tone can be misconstrued (seen it happen many, many times here on allnurses.com :rolleyes: ). I do appreciate you finding that last link for me; I have it bookmarked.

exnursie · Jan 28, 2010

I apreciate your open mindedness here, and will be the first to acknowledge the misconstrued way that people view commments when in the written manner.

Let me clarify something here, I personally have no objection to this issue, and know several people in recovery with chronic pain conditions that require narcotics to control their pain and allow people to lead a halfay normal life.

My concern is about how the BON sees this issue, and they are like many in the recovery world, and take a zero tolerance view on using narcotics. I realie now that this was not clear, and apologize. My main focus when respondong to people here is based on getting thru the monitoring in the best way. I have seen too many others who have been in your place, and the BON's have never said ":OK. NO PROBLEM," In the worst case, they will say nonvompliance, and in the best case, expect to be drug tested a lot more, and monitored closer, and often they will look for any little thing that can be a violation, ie, late paperwork, or asking about work....

As I said, I have no experience dealing with chronic pain, and have always felt bad for those who do when monitored and unable to use meds that work the best.

LilRedRN1973 · Jan 28, 2010

Thank you for that. I do have chronic pain but thankfully, it's fairly mild (I have had rheumatoid arthritis since I was about 30 and used to take large amounts of narcotic pain meds, justifying the use because of my RA). I have found other ways to deal with it when the pain is severe in my hands and best of all, have learned to ask for help with things like picking up my son, which I cannot do when the joints in my hands and wrists are swollen.

I do understand how the BON looks at the use of meds and have been very cautious in regards to this issue. I have had nothing but good experiences with my BON and they have been very supportive through the death of my grandfather and 7 months later, the death of my mother. I did get tested 3 times the month after my mother passed away and I don't believe this was a coincedence! :) I also know it wouldn't take much for me to fall out of their "good graces"....lol. This is why my doctor filled out the form that our BON requires when being prescribed any time of controlled substance, etc. and had him fax it to them. I did not hear back from them but when I meet with the DAC to request my narcotic privileges back (sometime in the coming months....I don't necessarily need it back because of where I work but I understand it's a sign of progress), I am going to discuss this very issue with them and get it in writing that this is acceptable. If not, then it will be back to square one to figure out how to get through the severe migraines without wanting to kill myself (half-joking here). I'm a big believer that unresolved pain can be a huge trigger for relapse and I don't want to go down that road. :rolleyes:

morte, LPN, LVN · Jan 29, 2010

check for a PM!

jackstem · Jan 29, 2010

MIDRIN's ACTIONS: Isometheptene Mucate, a sympathomimetic amine, acts by constricting dilated cranial and cerebral arterioles, thus reducing the stimuli that lead to vascular headaches. Dichloraiphenazone, a mild sedative, reduces the patient's emotional reaction to the pain of both vascular and tension headaches. Acetaminophen raises the threshold to painful stimuli, thus exerting an analgesic effect against all types of headaches.(from http://www.migraines.org/treatment/promidrn.htm)

The Talbott Recovery Center has a booklet (download it for free at the above link) discussing which medications to avoid and which ones are safe. They classify medications using these guidelines:

Class A Drugs (Absolutely Avoid)
Class B Drugs (With Addiction Medicine Specialist/Doctor Approval Only)
Class C Drugs (Generally Safe to Take)
Alcohol-Free Products
Incidental Exposure Index Listing of things to avoid that may cause a "false positive" screen for alcohol. Examples include: Purell Hand Sanitizer (60% alcohol.), personal hygiene products such as mouth wash (up to 20% alcohol) and others.

Class A drugs must be avoided completely, as they are well known to produce addiction and are the most dangerous of all. Only under very unusual conditions can Class A drugs be taken by a recovering addict or alcoholic, and only when given by a physician or dentist and with the consent of the addiction medicine physician that follows your care. These exceptional circumstances can include severe illness and injuries, including major surgery, car accidents and other trauma, and tests or procedures that can only be done under sedation or anesthesia. Medication treatments for certain psychiatric conditions are in this category as are medications used for drug detoxification. The street names for relevant drugs are also included in Class A. (from the guidebook)

Midrin is in the Class A medications under "Other Sedative/Hypnotics"
Other Sedative-Hypnotics:
Ambien (zolpidem)
Doriden (glutethimide)
Librax (chlordiazepoxide/clidinium)
Lunesta (eszopiclone)
Midrin (acetaminophen/dichloralphenazone/isometheptene)
Miltown (meprobamate)
Noctec (chloral hydrate)
Placidyl (ethchlorvynol)
Quaalude, Sopor (methaqualone)
Soma (carisoprodol)
Soma Compound (carisoprodol/aspirin)
Sonata (zaleplon)
These drugs act on the central nervous system and have the potential for drug dependency and abuse. Withdrawal symptoms can be seen if stopped suddenly.

Hope this is useful.

Jack

LilRedRN1973 · Jan 29, 2010

Thanks, Jack! I will print this out as well as information from that link and give it to my doc. We will have to continue looking for another treatment for the migraines, I guess. At least the propanolol has cut down on how many I get, which is a relief in itself. Much appreciated for the information (I knew you would be able to provide something!) :)

jackstem · Jan 29, 2010

Thanks, Jack! I will print this out as well as information from that link and give it to my doc. We will have to continue looking for another treatment for the migraines, I guess. At least the propanolol has cut down on how many I get, which is a relief in itself. Much appreciated for the information (I knew you would be able to provide something!) :)

I think I forgot to put the link to the Talbott Medication Guidebook. You can find it hear and it's free to download (PDF file).

Jack

http://www.dopl.utah.gov/programs/urap/forms/MedGuide.pdf

yellahorse · Feb 2, 2010

I just went befor the board and they reccomended me getting my license reinstated yea for me. I haven't received the paperwork yet. They want me to be in a board monitered drug program, not TPAPN. I'm kinda concerned about this, any ideas on what it is?

I also have migraine HAs and am taking Topamax; so far with no releif.

anyway let me know if any advise on preventive and or the board monitered program. Thanks