Zoloft migraine side effect


Side effects of sertraline - NHS

Like all medicines, sertraline can cause side effects in some people, but many people have no side effects or only minor ones.

Some of the common side effects of sertraline will gradually improve as your body gets used to it.

Some people who take sertraline for panic attacks find their anxiety gets worse during the first few weeks of treatment. This usually wears off after a few weeks, but speak to your doctor if it bothers you. A lower dose may help reduce your symptoms.

Common side effects

These common side effects of sertraline happen in more than 1 in 100 people. There are things you can do to help cope with them:

Feeling sick (nausea)

Try taking sertraline with or after food. It may also help if you avoid rich or spicy food.

Headaches

Make sure you rest and drink plenty of fluids. It's best not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking sertraline. Talk to your doctor if they last longer than a week or are severe.

Being unable to sleep

Take sertraline first thing in the morning.

Feeling sleepy

Take sertraline in the evening and cut down the amount of alcohol you drink. Do not drive, ride a bike or use tools or machinery if you're feeling sleepy. If this does not help, talk to your doctor.

Diarrhoea

Drink plenty of water or other fluids to avoid dehydration. Signs of dehydration include peeing less than usual and having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take contraceptive pills and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Dry mouth

Chew sugar-free gum or suck sugar-free sweets.

Feeling dizzy

If sertraline makes you feel dizzy, stop what you're doing and sit or lie down until you feel better.

Feeling tired or weak

If sertraline makes you feel tired or weak, stop what you're doing and sit or lie down until you feel better. Do not drive, ride a bike or use tools or machinery if you're feeling tired.

It's best not to drink alcohol as it will make you feel worse. If these symptoms do not go away after 1 or 2 weeks, ask your pharmacist or doctor for advice.

Keep taking the medicine, but speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects

It happens rarely (in less than 1 in 100 people), but some people may have serious side effects when taking sertraline.

Book an appointment with your doctor if you get:

  • changes in your periods, such as heavy bleeding, spotting or bleeding between periods
  • weight gain or weight loss without trying

Call a doctor or contact 111 now if:

  • you have feelings of overwhelming happiness (euphoria), excessive enthusiasm or excitement, or a feeling of restlessness that means you cannot sit or stand still
  • the whites of your eyes turn yellow, or your skin turns yellow (this may be less noticeable on brown or black skin) – these can be signs of liver problems
  • you cough up blood or have blood in your pee
  • you have black or red poo or blood in your vomit – these can be signs of bleeding from the gut
  • you are bleeding from the gums, or get bruises that appear without a reason or that get bigger

Go to 111. nhs.uk or call 111.

Immediate action required: Call 999 or go to A&E now if you:

  • get chest pain or pressure, or shortness of breath
  • get headaches, have trouble focusing, have memory problems, cannot think clearly, have weakness, have a seizure or fit, or lose your balance – these can be signs of low sodium levels
  • have thoughts about harming yourself or ending your life
  • get severe dizziness or pass out
  • get painful erections that last longer than 2 hours – this may happen even when you're not having sex
  • get any heavy bleeding or bleeding that you cannot stop, such as cuts or nosebleeds that do not stop within 10 minutes

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to sertraline.

Immediate action required: Call 999 or go to A&E now if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

Long-term side effects

A few people may get sexual side effects, such as problems getting an erection or a lower sex drive. In some cases these can continue even after stopping the medicine. Speak to your doctor if you are worried.

Taking sertraline for more than a year has also been linked to a small increased risk of getting diabetes. You'll be regularly checked for this.

Other side effects

These are not all the side effects of sertraline. For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 2 February 2022
Next review due: 2 February 2025

12 Zoloft Side Effects - SSRI Uses & Common Interactions To Know

Remember the original Zoloft commercial? The one where a sad little blob rolled around on screen with a rain cloud hovering over its head?

That commercial first debuted back in 2001, and since then Zoloft, or Sertraline hydrochloride, has become one of the top psychiatric drugs used by American adults, according to one recent study.

“Zoloft is one of the first-line antidepressant medications prescribed for both depression and anxiety, meaning it’s one of the most likely to work,” says Alison Hermann, MD, a clinical psychiatrist at Weill Cornell Medicine and New York-Presbyterian Hospital.

Zoloft is part of a class of drugs called SSRIs, or selective-serotonin reuptake inhibitors. “Their main effect has to do with changing the signaling of one of the main neurotransmitters in the brain, serotonin, which modulates mood,” explains James Murrough, MD, the director of the Mood and Anxiety Disorders Program at the Icahn School of Medicine at Mount Sinai. “These medicines tend to increase the availability of serotonin in the brain, which can help boost your mood.”

And that’s the goal, right?

In general, antidepressants are well tolerated. But, like with all drugs, there are Zoloft side effects—some of which are merely annoying and some of which can actually be dangerous. “I generally start my patients on the lowest milligram pill and have them cut it in half for the few few doses just to make sure you’re tolerating it before bumping it up,” says Dr. Hermann.

So if you’re prescribed Zoloft, here’s what to look out for.

1

Changes in Weight or Appetite

People taking Zoloft gained nearly two pounds over the course of a year, according to one study published in the journal JAMA Psychiatry. It’s not the only SSRI linked with weight gain, but if that’s a concern for you, talk to your doctor about your options.

2

GI Effects

“Interestingly, there’s actually a lot of serotonin in the gastrointestinal tract, so people on Zoloft can experience changes in GI function,” says Dr. Murrough. “That could mean an upset stomach, nausea, or changes in bowel habits like constipation or diarrhea. ” Dr. Murrough suggests starting on the lowest possible dose to avoid these issues, then increasing the dosage as your system acclimates to the extra serotonin.

3

Sexual Side Effects

This is one of those side effects no one wants to talk about, but it can affect at least a third of patients on SSRIs, says Dr. Murrough. “We don’t know why drugs like Zoloft have sexual side effects, but people can experience things like difficulty orgasming, a lack of sex drive, or the inability to get or maintain an erection.” For some people, the benefits of the medicine will outweigh the negative effects on their sex life; for others, a change in medication may be necessary.

4

Increased Anxiety

Another one of the more common Zoloft side effects is called akathisia. “It’s like feeling amped up or restless, like you need to move, or like you’re unable to calm down,” explains Dr. Hermann. In some cases, akathisia can even feel like a panic attack. But akathisia can be mitigated by starting on a really low dose and slowly working your way up, she adds.

5

Mood or Behavior Changes

Obviously, you want your mood to change while taking an antidepressant or anti-anxiety drug. “But the mood or behavior change that we’re most worried about as mental health professionals is increased depression or suicidal thoughts or a switch from depression to mania,” says Dr. Hermann. “Any antidepressant intervention has the potential to flip someone who’s vulnerable, who has bipolar disorder rather than depression, into a mania, which is why it’s so important to make sure you have the right diagnosis before starting medication.”

6

Night Sweats

“Nighttime sweating is a common side effects of SSRIs, and Zoloft is one of the drugs where it’s more common,” says Dr. Hermann. “It’s not dangerous at all, provided that the person is seeing an internist regularly and has had a physical exam and lab work within the year to indicate there’s nothing else responsible for it.” It is uncomfortable, though, so Hermann recommends wearing sweat-wicking materials to bed and keeping your bedroom cool enough at night.

7

Serotonin Syndrome

“This is a catch-all term for what happens when there’s too much serotonin in the body,” says Dr. Murrough. “It affects your blood pressure, can cause severe GI symptoms, and can even lead to confusion, fevers, and seizures—in extreme cases, it’s life-threatening.”

The risk is very low for people who are just taking one medication, but if someone is on several medications that affect serotonin levels, the risk level rises. “Sometimes, people describe this as a bad flu—so on the off chance that happens, call your doctor right away,” says Dr. Murrough. “The treatment is to simply stop the medication.”

8

Trouble Sleeping

In most cases, antidepressants and anti-anxiety meds help people sleep better. But, occasionally, “people report unusual dreams, restlessness during sleep, or feeling like their sleep is altered in some way,” says Dr. Hermann.

This is a potential risk of taking something that affects your brain, says Dr. Hermann, and if it’s disruptive enough to your life, your doctor might try you on a different drug.

9

Rashes

Sometimes people can develop rashes or increased skin sensitivity while taking Zoloft, says Naema Qureshi, MD, a psychiatrist at Brooklyn Minds. It’ll usually go away on its own, and you can find relief in the mean time with an over-the-counter anti-itch cream.

“However, if you show signs of an allergic reaction, such as hives, itchiness, or throat swelling shortly after you start Zoloft, you should stop taking it and report these symptoms to your doctor immediately,” says Dr. Qureshi.

10

Headaches

Headaches are common when you first start taking Zoloft, or when you increase the dose, says Dr. Qureshi.

“For most people, headaches go away after a week or two as your body adjusts to the medication,” she explains. “If you experience occasional headaches while starting the medication, you can try common over-the-counter pain relievers such as Tylenol.”

If your headaches are persistent, Dr. Qureshi recommends talking to your doctor, as it’s possible you may tolerate a different medication better.

11

Dry Mouth

Dry mouth is another common side effect of Zoloft which can sometimes persist, says Dr. Qureshi.

“It's important to pay attention to dry mouth because it can increase your risk of cavities and other oral issues,” she says. “In addition to maintaining good oral hygiene and hydration, you could consider trying a toothpaste or mouthwash specifically designed for dry mouth.

12

Rare Side Effects

While most people tolerate Zoloft well, patients can experience rare but serious side effects such as vision changes, seizures, confusion, and dizziness while taking it, says Dr. Qureshi. Talk to your doc about any underlying conditions you have before you start any new meds, how Zoloft might interact with anything you're already taking, and seek immediate help if you start experiencing any of these uncommon side effects.

Ashley Mateo Ashley Mateo is a writer, editor, and UESCA- and RRCA-certified running coach who has contributed to Runner’s World, Bicycling, Women's Health, Health, Shape, Self, and more.

Emilia Benton Emilia Benton is a Houston-based freelance writer and editor.

Zoloft instructions for use: Side effects, analogs, contraindications

Basket

POSSIBLE SIDE EFFECTS. A SPECIALIST'S CONSULTATION IS REQUIRED.

Author of the article

Khokhrina Kristina Sergeevna,

pharmacist

All authors

Content of the article

  • Zoloft: active ingredient
  • Zoloft: side effects
  • Zoloft: Contraindications
  • Zoloft and alcohol
  • Zoloft: overdose
  • Zoloft: How to stop drinking it
  • Zoloft: Anges
  • Summary
  • Ask the expert on Article

on the STO from the Deposit estimates of the WHO from the deposits .8% of the total population, which is 280 million people. Among them, 5% of adults and 5.7% of persons over 60 years of age. More than 700,000 people die each year from suicide due to depression. Depression is treatable with medication. nine0003

Doctors prescribe antidepressants. Zoloft is one of them. We asked pharmacist Kristina Khokhrina to tell us in more detail: what side effects it can cause, what active ingredient, contraindications, overdose, is the drug compatible with alcohol and how to stop drinking it.

All products Zoloft

27 reviews

Zoloft: active ingredient

Zoloft contains the active ingredient - sertraline in the form of hydrochloride. It is produced in tablets with a dosage of 50 mg and 100 mg. Zoloft is an antidepressant. It is used to treat and prevent depression caused by various causes. And also when: nine0003

  • obsessive-compulsive disorders
  • panic disorders
  • post-traumatic stress disorder
  • social phobias

How Zoloft works

Zoloft helps to eliminate depressive manifestations:

  • relieves anxiety
  • normalizes sleep
  • reduces somatic manifestations: palpitations, disruption of the gastrointestinal tract, increased excitability. nine0024

Zoloft does not cause dependence on the drug and does not lead to weight gain in humans.

Zoloft side effects

Watch your condition carefully while using the medicine. If you experience side effects that are not described or if symptoms worsen, contact your doctor immediately.

Zoloft: side effects

  • flatulence, nausea, vomiting, diarrhea, constipation, abdominal pain, dry mouth
  • increased heart rate, increased blood pressure nine0024
  • arthralgia, muscle cramps
  • gait disturbance, teeth grinding, drowsiness, syncope, headache, migraine, tremor, insomnia, anxiety, hallucinations, psychosis, nightmares, decreased libido, suicide, coma
  • yawning, bronchospasm
  • bedwetting, urinary retention during the day
  • hepatitis, jaundice
  • decrease in potency, disruption of the reproductive system, menstrual cycle disorders in women
  • visual impairment
  • thyroid disorder
  • urticaria, pruritus, anaphylactic shock
  • flushing, tinnitus, loss of appetite and others

Zoloft: contraindications

  • hypersensitivity to any component of the preparation
  • concomitant use of monoamine oxidase inhibitors and pimozide
  • pregnancy and lactation
  • children under 6 years of age nine0024

Caution must be taken in: mental retardation, epilepsy, renal and/or hepatic insufficiency, marked reduced body weight.

Zoloft and alcohol

Alcohol is not recommended to be taken with the medicine. Its action can increase side effects and lead to overdose.

Learn how to recognize depression in the article "The Beck Test for Depression"

Zoloft: overdose

Zoloft overdose occurs when used simultaneously with alcohol or other incompatible drugs. With such combinations, severe poisoning can occur, up to coma and death. Overdose symptoms are: nine0003

  • nausea
  • vomiting
  • drowsiness
  • increased heart rate
  • dizziness
  • psychomotor agitation
  • diarrhea
  • excessive sweating

Hospital observation and constant monitoring of vital signs will be required. When first aid is not recommended to induce vomiting, it is better to give activated charcoal.

Zoloft: how to stop drinking it

"Withdrawal" syndrome is rare. Nevertheless, it is necessary to discuss with the doctor a decrease in the dosage of the drug. Since the termination of treatment is possible: nine0003

  • symptoms of depression
  • hallucinations
  • aggression
  • anxiety
  • psychosis

Particular attention should be paid to the fact that after the end of the use of Zoloft, within 14 days, you should not take drugs related to monoamine oxidase inhibitors.

Zoloft: analogues

Zoloft has about 10 names of analogues of the active substance. All medicines are prescribed and prescribed by a doctor. Therefore, to choose a remedy or replace your own, consult your doctor first. nine0003

Zoloft and Atarax: compatibility

The combination of these drugs increases the side effects. This manifests itself in the form of dizziness, drowsiness and confusion. Elderly people have difficulty in thinking and coordinating movements.

Do you want to understand analogues of drugs in order to skillfully select drugs for your budget? Our manual from expert pharmacists "Analogues of popular drugs" will help you with this! nine0014 Getting a training manual is easy: subscribe to our social networks and write “analogues” in the messages.

Megapharmacy in social networks: VKontakte, Telegram, OK

Summary

  • Zoloft is an antidepressant that is taken to prevent and treat depression and other disorders.
  • Zoloft may have a significant number of side effects.
  • The active substance is sertraline, dosage in tablets of 50 mg or 100 mg.
  • Zoloft has contraindications that should be taken into account when prescribing it. nine0024
  • It is not recommended to use alcohol together with Zoloft to avoid overdose symptoms.
  • An overdose of the drug occurs when used simultaneously with certain drugs and alcohol.
  • Zoloft is not usually addictive, but you should consult your doctor before stopping it.
  • Zoloft has several analogues, but only a doctor can replace them.

Ask an expert about the topic of the article

Still have questions? Ask them in the comments below and our experts will answer you. There you can also share your experience with other readers of Megasovets. nine0003

Share the mega tip

Like this article? Tell mom, dad, grandma and aunt Galya from the third entrance

Copy link

Guide to analogues for a subscription

subscribe to social networks and write "analogues" in messages

Share

What is chronic migraine and how to treat it 9002 Elena Kochubey

treats chronic migraine

Author profile

I have been living with migraine for 30 years, in recent years the attacks have become more frequent and more severe. nine0003

If you want to offend a person who has a migraine, in response to another complaint, say: “Who doesn't get a headache? Take a pill and everything will go away. " Resentment is guaranteed to you, because a migraine is not just pain. A bonus to pain is nausea, in severe cases, vomiting, inability to concentrate on something, increased sensitivity to light, sounds and smells.

Migraine is a disease that impairs the quality of life when you have to sacrifice work, communication with loved ones, even just a new book that you have long dreamed of reading. nine0003

I will tell you in which cases migraine is considered chronic, what to do if the head hurts very often and what methods helped me.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you. nine0003

What is considered a chronic migraine

According to the International Classification of Headaches, a chronic migraine is a headache that occurs more than 15 days a month for three or more consecutive months.

Chronic migraine - Uptodate

A minimum of eight attacks per month must meet the criteria for migraine. That is, such pain must have at least two of the following signs:

  • pain on only one side of the head;
  • pulsating;
  • aggravated by exercise;
  • moderate or severe.

In addition, there must be one thing during an attack of pain: nausea or vomiting, or increased sensitivity to light or sound.

Chronic migraine affects approximately 2% of people worldwide. Such a migraine reduces the quality of life more than an episodic one; it often leads to the fact that a person cannot work normally.

Why migraines become chronic

Kirill Skorobogatykh

neurologist, cephalologist, head of the University Headache Clinic

Chronic migraine can be described as follows: it is a migraine attack that cannot end in any way, that is, one attack flows into another. It is believed that in such cases, the brain structures responsible for the occurrence of pain are constantly in an active state.

Chronic migraine always evolves from episodic migraine. This does not happen in all patients. So, in Russia, approximately 6-7% of people suffer from chronic migraine, and in total migraine is recorded in 20% of the population - it becomes chronic in less than half. nine0003

The transformation of episodic migraine into chronic occurs for various reasons, some of which we do not know. But some risk factors for migraine progression are known, for example:

  • female;
  • traumatic brain injury in the past;
  • overweight;
  • snoring;
  • excessive use of painkillers;
  • a migraine attack that has not been fully resolved, when a slight headache remains after taking painkillers. nine0024

The most powerful factors that lead to migraine chronicity are anxiety and depressive disorders. It is not known exactly why this happens, but it is clear that such disorders and chronic migraine have common biological mechanisms of development.

How I lived with headaches since childhood and I could not be diagnosed

I have been suffering from headaches since childhood, for about 30 years. If you believe the records in the medical card, then from the age of 13. Consistently once a week, I skipped school due to severe pain that painkillers could not relieve. At that time, all doctors had the same diagnosis - VVD, or vegetovascular dystonia. nine0003

It seems to me that it was the desire to find that very “magic pill for the head” that led me after school to the Volgograd Medical Academy to the Faculty of Pharmacy. During my studies, I decided that my head began to hurt more due to high loads at the institute, and I began to take nootropics, in particular piracetam and others, as well as B vitamins.

/vsd/

there is no diagnosis

Nootropics were thought by many at the time to help the brain cope with stress, although in reality such drugs have no proven effectiveness. Of course, they did not affect my migraine and did not bring relief. nine0003

It only got worse with time. Headaches became more frequent: two or three days a week, the head hurt steadily, either on the right or on the left. The pain throbbed tediously in the brain and radiated to the eye. True, in most cases it was not too intense and was muffled with ordinary painkillers.

However, there were also severe attacks. They often began not with pain in the temple, as usual, but with the neck, and only after a while the pain appeared in my usual place.

At that time, I still did not know that I had a migraine. Another non-existent diagnosis appeared on the card next to the VSD - osteochondrosis, and that was it. nine0003

/osteochondrosis/

How much does it cost to cure osteochondrosis

The very first entry with a complaint of regular headache, which in those days I took off with a painkiller pill. The doctor diagnosed vegetovascular dystonia. It was 1993

About migraine and drugs that were specially created to relieve attacks - triptans - I learned when I started working in a pharmacy. I just saw a box with one of the products on the shelf, read the instructions and decided to try it.

There is no need to repeat my experiment. Triptans are a serious group of drugs with side effects and contraindications. Only a doctor should prescribe them after making a diagnosis.

The drug I chose cleared up the pain in about 40 minutes. Life became easier, even despite the weakness and drowsiness that appeared after taking it. For a while, I was saved by this remedy. Until the first very strong attack happened, which put me in bed with wild pain for three days. Stress became a provocateur, and none of the usual remedies could relieve the pain, including triptan, which I myself prescribed. nine0003

After that, I again went to the neurologist at the regular district clinic. The only study that I was assigned there was an x-ray of the cervical spine. Most likely, because I complained about the pain in the neck that occurs before the attack.

/migraine-kids/

How to treat migraine in children and adolescents

X-rays could be taken free of charge through compulsory medical insurance, but I had to wait in line, so I did it for a fee in the same district clinic for 350 R. The result was all those VSD, osteochondrosis and "something is wrong with the vertebral arteries", a massage course with a total cost of 5000 R, droppers "for blood vessels" and again nootropics. nine0003

In 2017, I stumbled on a lecture about migraine quite by accident on the Internet. She helped me understand that the treatment that I was prescribed earlier had nothing to do with this. By that time, my migraine had become chronic, the attacks became more frequent, I suffered from headaches up to 25 days a month.

Truth and myths about migraine and its "sisters" - a lecture by neurologist Kirill Skorobogatykh

Later I turned to a private clinic. The visit cost 1500 R, I chose a neurologist based on reviews. Then I had almost no doubt that I had a migraine, I wanted to choose a scheme for preventing attacks. nine0003

In a private clinic, the doctor was very surprised that before that I had never been sent for an MRI of the brain, and she hurried to correct it. When I asked why this was necessary, the answer was: "You have never done an MRI, just in case you need to." As a result of the appointment, they issued a referral for an MRI of the brain with angiography that I did not need and an inappropriate treatment regimen. I didn't do any research.

There was still one positive moment in my trips. I finally received a diagnosis of "cephalalgia of the type of paroxysmal hemicrania" - this is a rather rare type of headache. Not a migraine, of course, but at least close. Admittedly, it didn't help me much. The doctor prescribed a drug that improves blood circulation in the brain and a drug that relaxes the muscles. This treatment had no effect on my migraine. nine0003

/guide/nootropics/

Nootropics: do they really improve brain function

The same statement in which they first pointed out something close to migraine to me, 26 years have passed since the first entry

How I was diagnosed with migraine

After the visit I did not go to a private clinic for two years, as there was no time, in addition, I was a little disappointed in medicine during the time that they could not help me.

In 2021, I nevertheless turned to another neurologist, also in a private clinic, as the pain continued to interfere with my life. He eventually made the correct diagnosis by simply asking me:

  1. When did headaches start to bother you?
  2. How many days a month have I had a headache in the last three months?
  3. How exactly did she get sick: on which side, the pain is throbbing or aching, how strong is it on a ten-point scale?
  4. Did the nature of the pain change, if so, how and when did it happen?
  5. What medications did I take to relieve the attack, how well did they help me?
  6. Do I have other chronic diseases? nine0024

The neurologist diagnosed me with chronic migraine without aura. Aura refers to various neurological symptoms that appear some time before the onset of pain. These can be, for example, visual impairments, spots before the eyes, numbness of the face or some parts of the body. I didn't have anything like that.

I paid 1500 R for the doctor's appointment. Due to additional complaints, I was prescribed tests for which I paid another 1530 R: complete blood count, blood tests to evaluate thyroid function and ferritin. Ferritin helps to assess iron levels, in some cases, anemia can be the cause of headaches associated with the menstrual cycle. nine0003

/anemia/

How to treat anemia and how much it costs

I recommend preparing for a doctor's visit in advance. You can write down information on a piece of paper so that you don’t forget anything. The ideal option is to keep a headache diary, where you need to write down the frequency, duration, strength, characteristics of the attacks and what you think caused them. If you have previously prescribed an MRI of the brain, ultrasound of the vessels or other studies, they may also come in handy.

Headache diary template

An extract from a clinic that finally has a diagnosis of migraine

For the sake of interest, I decided to calculate how much time and money a headache has taken me over 20 years from the moment I first tried to relieve an attack on my own with a triptan. It turned out that I spent about 184,800 rubles on medicines. the usual pills did not help. In reality, the cost of medicines will be even higher. nine0003

Before I was diagnosed with pills, I was taking approximately 9240 R per year

Drug How many packs per year Cost per year Cost for 20 years
Solpadein pain tablets 27 5670 R 113 400 Р
Sumatriptan 21 3570 R 71 400 R

Anesthetic tablets "Solpadein"

How many packages per year

27

Cost per year

9000 5670 R

Cost for 20 years

113 400 r

Suppetan 0 9000 9000 year

21

Cost per year

3570 R

Cost for 20 years

71 400 R

brain, ultrasound of the vessels of the neck or other studies.

A thorough examination is needed only in some cases to exclude dangerous headaches associated with some diseases, such as cancer. nine0003

The neurologist orders additional tests if he sees threatening symptoms, they are called red flags:

  1. Headache associated with other symptoms, such as a rash on the body or high fever.
  2. Pain is accompanied by neurological problems, such as loss of vision, weakness in the arms or legs.
  3. The headache is very severe and comes on suddenly, its intensity is increasing.
  4. Headache first appeared after 55 years. nine0024
  5. The headache has changed - for example, a person used to have a headache all over his head and not much, but it began to hurt in the back of the head and more strongly.

If there are no alarming symptoms, the neurologist can make a diagnosis after a detailed interview of the patient, no examinations are required for this. Primary headaches that are not associated with dangerous diseases, such as migraine and tension headache, differ from each other in the nature of sensations. If a doctor finds out how, where, when and after what a person has a headache, in most cases he can immediately make an accurate diagnosis and choose the right treatment. nine0003

How I was diagnosed with anxiety

Many patients with migraine, especially chronic migraine, suffer from generalized anxiety disorder, depression, and panic attacks. Sometimes they are not aware of it, as was the case with me.

The Relationship Between Depression, Anxiety, and Migraines - Migraine Foundation of America

My head was churning for no reason, it seemed like something bad was bound to happen. It got to the point that when troubles happened, I even felt relieved. nine0003

I had trouble sleeping. Often I couldn't sleep or kept waking up during the night. As a result, fatigue already in the morning, lack of desire to do something, even if earlier these things brought pleasure. I attributed all this to a headache and did not even think that the reason could be something else.

/trevoga/

How I Treated Generalized Anxiety Disorder under CHI

At the first appointment, the neurologist gave me a test to assess the level of anxiety and depression. This happened after I talked about my problems with constant anxiety and sleep. nine0003

The test consisted of statements with four possible answers, from which I had to choose the one that best suited my condition. He showed that I had clinically expressed anxiety, which made migraine attacks even more severe.

Online test for the level of anxiety and depression

Is it necessary to detect and treat anxiety and depression in people with migraine

Kirill Skorobogatykh

neurologist, cephalologist, head of the University Headache Clinic

Patients with chronic migraine should always be tested for anxiety and depressive disorders. If this is not done, they can be skipped, which will negatively affect further treatment:

  1. Migraine therapy can affect the mental state. For example, some chronic migraine medications can make depression worse.
  2. Depression and anxiety in themselves greatly reduce the quality of life, they must be treated.
  3. It will be difficult to manage chronic migraine if there is untreated anxiety or depression. These conditions will again translate the migraine into a chronic form. nine0024

To diagnose anxiety and depressive disorders, a doctor of any specialty can use simple screening tests, such as the Hospital Anxiety and Depression Scale, the Hamilton Depression and Anxiety Scale, the Beck Depression Scale, and others. If the doctor cannot cope with the treatment of anxiety or depression, the patient should be referred to a psychiatrist.

How do I track the frequency of migraine attacks? How many days a month I had a headache, I already remembered. nine0003

Headache Diary - British Migraine Foundation

Migraine Diary - National Migraine Center UK

I don’t know what causes them, except for stress and high workload, and I have no idea how long my head hurts if I don’t take the pills on time.

It turned out that all this is important both for making a diagnosis and for selecting the most effective therapy. Another headache diary will help control the amount of painkillers, which means avoiding the development of overuse headache caused by frequent medication. nine0003

With the help of the diary, I saw that cold, deviation from the usual daily routine and too much sleep also cause migraines. The last one was a revelation for me. After all, many people like to lie around longer on a day off, it turned out that with a migraine, a daily regimen is often mandatory.

/list/headaches/

9 important questions to neurologist Kirill Skorobogatykh about headaches

To begin with, I made myself a plate that can be filled out by hand. Then I got ready-made forms for a headache diary that the doctor gave me. The trouble is that they also need to be filled in manually, I did not always remember this. nine0003 The very first version of the headache diary. I marked the drugs with different colors, highlighted in red the days when my head hurt, and tried to write down what exactly caused the attack. These diaries were given to me by a neurologist. pain. For example, telegram bot "Migrebot". He himself recalls the diary, asks how exactly the head hurt, tells how many pills he took per week and month, sends reports to the mail. nine0003

In general, this is a handy assistant, but I did not like how it displays the result of filling out the diary - in the form of a simple table. I like graphs and charts more, they are clearer. Now I use the mobile application "Migraine Compass".

8 health apps

The application shows attacks of pain, including in the form of graphs Over the past year, a migraine took me 40 days

How do I manage my migraine attacks

To date, migraine cannot be completely cured. But there are drugs that help bring the disease under control.

Migraine - MSD Physician's Handbook

Migraine - NHS

Nonsteroidal anti-inflammatory drugs and pain relievers. These drugs can be bought at a pharmacy without a prescription, their active ingredients are paracetamol, ibuprofen, naproxen and others.

As a rule, they are used first, and if they do not relieve the attacks, they prescribe something else. I usually take such medicines in soluble form, they help me faster. nine0003

Migraine - Medscape medical guide

Anti-attack medications that I sometimes take. Source: "Eapteka" Drugs for relieving seizures, which I sometimes take. Source: "Eapteka"

Triptans. These preparations are specially designed to relieve migraine attacks.

Acute treatment of migraine in adults - Uptodate

There are seven drugs in this group, but only three are available in Russia:

  1. Sumatriptan - Sumamigren, Amigrenin, Sumatriptan-teva. nine0024
  2. Zolmitriptan - Zomig, Migrepam, Zolmitriptan-SZ.
  3. Eletriptan - Relpax.

For me, sumatriptan has become just a salvation, it relieved attacks quickly and completely. Unfortunately, over time it stopped working and I had to try zolmitriptan and eletriptan. These drugs in my case were not so effective.

If the attack is severe, I have to take 5 mg zolmitriptan and 1000 mg paracetamol in combination with caffeine to completely stop it. After that, the pain does not always go away, then after two hours I drink another soluble drug "Faspic". When the pain is not strong or an attack can be caught at the very beginning, two Solpadein tablets are enough. nine0003

I now use on average one package of triptan plus one or two regular painkillers per month.

Finding a good therapy to relieve an attack is not always easy. It would seem that the disease is the same for everyone, but painkillers and triptans act individually.

/list/medicines-analogues/

Drugs in neurology: how to understand what works and whether they can be replaced

Medicines for nausea and vomiting. Migraine headache is often accompanied by nausea and vomiting. Additional funds may be required to remove it. This rarely happens to me. But when it happens, then along with drugs to get rid of pain, I also take Motilium, in especially severe cases - Cerucal. nine0003

One package worth 150 R is enough for me for about three months.

How often can you take painkillers to avoid overuse headaches

Kirill Skorobogatykh

neurologist, cephalologist, head of the University Headache Clinic

Painkillers and special drugs for migraine - triptans - relieve headache attacks well. But if you need them more than twice a week, you should contact a specialist to reduce the frequency of attacks and reduce the amount of painkillers you take. nine0003

Taking any pain medication more than twice a week increases the risk of migraine becoming chronic and medication-induced abuse headache.

What do I use to prevent migraine attacks? There is a special preventive therapy that can reduce the number of attacks.

Migraine Treatment - Mayo Clinic Blog

Pharmacological prevention of episodic migraine in adults - recommendations of the American Academy of Neurology

Medicines. To prevent migraine, neurologists use several groups of drugs, such as antidepressants, drugs that reduce blood pressure, drugs for the treatment of epilepsy, and others. Usually they are prescribed for other diseases, but they also help with chronic migraine.

These drugs are started with the smallest dose, which is gradually brought to the minimum effective dose over two to three weeks. nine0003

Evaluating the effectiveness of therapy is very simple. If the number of seizures has decreased by at least two times, then prevention is working. At the same time, the quality of life should not suffer due to side effects.

My first preventive therapy: the antihypertensive drug metoprolol plus the tranquilizer tofisopam. This combination made me so dizzy that I even got up with difficulty. I steadfastly took the drugs for two weeks in the hope that the discomfort would pass. But it didn’t get better, while the head really began to hurt a little less often. Such treatment cost about 1200 R per month. nine0003

At the second visit, the doctor replaced tofisopam with the Zoloft antidepressant, but this drug did not suit me either. Such a scheme cost a little more, about 1300 R per month.

/list/antidepressant-myths/

8 myths about antidepressants

As a result, we settled on the third scheme: Ordiss, the antihypertensive drug, plus the antidepressant amitriptyline, which I still take now.

One pack of Ordissa and a little more than half a pack of amitriptyline was enough for me for a month. It costs about 650 R.

I noticed the effect of taking the medicine after a month. The migraine did not disappear completely, but the number of days with a headache decreased from 20-25 to 15-17 per month. The strength of attacks and their duration have decreased, now in most cases two Solpadein tablets are enough for me to stop them, I began to take triptan and other drugs less often - five times a month.

Scheme I am currently accepting. Source: "Eapteka" The scheme that I am accepting now. Source: "Eapteka"

Botulinum therapy. nine0436 These are botulinum toxin injections that cause muscle relaxation and thus help reduce the frequency and severity of headache attacks. For migraines, injections are made into the muscles on the head and neck.

I have not tried botulinum therapy yet. I stopped the cost of the procedure: in a private clinic it costs about 35,000 R and does not always give a good effect. The neurologist and I left this option as a last resort.

/migraine/

How much does it cost to keep a migraine under control

I spend about 2310 R per month on migraine pills

Preparations Cost
Ordinary painkillers 1180 Р
Anti-migraine preparations 650 P
Triptans 430 P
Anti-nausea 50 P

Ordinary painkillers

1180 P

Migraine prevention drugs

650 R

Triptans

430 R

Nausea drug

50 R

At that time, this group of drugs had just passed clinical trials and they began to be used in the USA and Europe.

Two drugs became available in Russia in 2020: fremanezumab - Ajovi and erenumab - Irinex.

Anti-migraine monoclonal antibody - Medscape

Such drugs block the action of CGRP, a protein compound involved in the mechanism of migraine development. Antibodies act selectively, attacking it.

Both drugs are available as injections for subcutaneous administration. The drug is already filled in small syringes, which is very convenient, especially if you do the injections yourself. Usually the scheme of application is as follows: one injection every four weeks.

The effect is evaluated after three months, the duration of therapy is individual depending on the severity of migraine, but averages 12 months. nine0003

In 2021, a neurologist told me about the migraine support program, by registering in which I can get the first Ajovi injection at a discount of about 70%, and all subsequent injections at a 50% discount. At that time, we had already changed drugs for the prevention of seizures once, both regimens did not help, so we decided to try this treatment.

Migraine Patient Support Program

I agreed and bought the first package, paying 5400 R for it, the second and third cost me 16 500 R. Now this program continues to operate - however, the prices for the drug could change. nine0003

38,400 R

I paid for a course of three doses of Ajovi

I did the injections myself in the anterior surface of the thigh. The instructions describe in detail how and where you can inject, in practice everything turned out to be very easy. At the injection site, I had redness and a small painful bump, as if I had hit something. There were no other side effects.

In the end, I was not lucky. I found myself in that category of people with migraine who have monoclonal antibodies to CGRP do not work. After three injections, the number of seizures remained the same as it was before the start of treatment. As the doctor explained to me, in some people completely different substances play a leading role in the development of an attack. nine0003

To date, there are no methods that help to find out exactly how an attack develops in a particular person, so choosing a drug is always a bit of a risk.

There is another new group of drugs - antagonists of the CGRP protein, which do not affect the protein itself, but the receptors sensitive to it. The first of these, Remigepant, or Nurtec, may soon be approved for use in the US and Europe. There is not a single representative of CGRP antagonists in Russia yet.

Neurologist's prescription recommending the use of monoclonal antibodies for migraine prevention Prescription for monoclonal antibodies

How preventive therapy is selected for migraine

Kirill Skorobogatykh

neurologist, cephalologist, head of the University Headache Clinic

The main goal of preventive therapy is to improve the patient's quality of life. If drugs cause side effects and discomfort, therapy should be changed. You also need to focus on the pros and cons of the drug for a particular patient. For example, there are medications for migraine prevention that can increase weight - they should not be prescribed to patients with such a problem. On the other hand, there are drugs that reduce appetite: for one person, this can be a negative effect, but for another, it can be the other way around. nine0003

If positive, prophylactic therapy should be continued for at least 12 months. The effect can be already in a month and a half, sometimes even faster - for example, if monoclonal antibodies are used. But it is not worth giving up treatment, you need to continue, as there is a possibility of a relapse if you cancel it earlier.

How I Tried Trigeminal Nerve Stimulation

Trigeminal Nerve Stimulation is an unproven treatment for migraines. For treatment, they use a device with the beautiful name "Cefaly" - Cefaly. Some studies of its effectiveness are paid for by the manufacturer of the device, others provide some evidence of effectiveness, but were conducted on a small sample. nine0003

Cephali acts with a low frequency current on the trigeminal nerve, which plays an important role in the development of migraine attacks. This may affect the course of the disease.

The device looks like an elf's diadem, inside it there are electrodes that send micropulses to the branches of the trigeminal nerve located in the forehead and above the eyes.

The device is not cheap - from 12,500 R for the device itself and one electrode for it, designed for 20 sessions. A package with three replacement electrodes costs from 1400 R. Therefore, for a start, I decided to just try, found a clinic with such a service and made an appointment. The initial session cost 1000 R, and all subsequent sessions cost 800 R. The course of treatment is prescribed individually: from two sessions per month for rare migraine to daily sessions if the attacks are frequent. nine0003

/rabotaet-ili-net-test/

Can you tell a real medical device from a useless one?

I only attended one session. That day I just had a headache. The hoop turned out to be much lighter than I thought, quite comfortable. It was necessary to get used to the sensations from it: as if a crowd of goosebumps on needle-like legs were running across the skin. I would not say that it causes great inconvenience, but it is not very pleasant either. I noticed the effect: the attack did not completely go away, but the pain decreased, that day I even did without pills. nine0003

How this works in the long run, I don't know. I was recommended daily sessions until the number of seizures decreased. But I don’t have the opportunity to go to the clinic every day, and buying a device at home is too expensive.

This is what the Cefali device looks like

Can neurostimulation be useful for migraine prevention

Kirill Skorobogatykh

neurologist, cephalologist, head of the University Headache Clinic

in the form of tablets or injections. nine0003

To prevent migraine, this device should be used for 20 minutes daily for at least three months. But such therapy has no side effects - however, some people cannot bear the sensations that arise during the operation of the device.

How do I manage my migraine triggers? The most common are increased physical or emotional stress. For example, when I was studying and working in a pharmacy at the same time, migraines occurred more often and more strongly, especially after night shifts. nine0003

Clinical manifestations and diagnosis of migraine in adults - Uptodate

When I graduated from university and started working only during the day, my condition improved for a while. But a difficult shift or troubles still ended in an attack. Migraine appeared not only after negative, but also after pleasant events. For example, going to the cinema, to a concert or to visit always ended in a headache.

I tried to cope with this with the help of sedatives such as Afobazol and Adaptol, I took Mildronate. None of these drugs help with migraine, in addition, they have no proven effectiveness at all. But then I didn't know about it yet. nine0003

Another trigger for me was food. Here I was a little lucky: the only thing I had to give up completely was alcohol, spicy, pickled and fatty foods. As for other common triggers, like chocolate, coffee, cheeses, or citrus fruits, I can eat them in small amounts.

My migraine allows me to drink one or two cups of not very strong coffee, eat a few grams of chocolate or an orange. The main thing is not every day and not all together.

Mode also affects migraine attacks. It is better to get up and go to bed at the same time, no concessions even on a day off. Sleep no less, but no more than seven or eight hours a day.

/keep-calm-and-sleep/

"Thoughts about how sleep should be often interfere with sleep." Psychologist - about sleep during stress

It was hard for me to follow this rule. I could easily sit up until the morning with an interesting book or series, sleep until lunch on a day off, do all the work without rest, because I want to hurry up. I had to educate myself. I won’t lie that now I strictly follow the compiled regimen, but I honestly try. nine0003

The second enemy of migraine is physical activity. Yoga has been a real lifesaver for me. I was too lazy to go to the gym, so I studied at home, using the application on my phone. I started with 15 minutes every other day, gradually reached 40 minutes. It was difficult, I had to force myself, but over time I got used to it. I began to get great pleasure from classes and I don’t understand how I managed without them before.

Remember

  1. If your headache occurs more than four times a month, it's time to go to a neurologist and choose a prevention method. Chronic migraine is considered when there are more than 15 attacks per month, but it is better not to bring it to this. nine0024
  2. A doctor can make a diagnosis of migraine only based on the results of a survey, if there are no symptoms that indicate dangerous diseases.
  3. It is impossible to take painkillers for migraine without control, as this can only increase the headache and increase the number of attacks.
    Learn more