Tylenol / acetaminophen question

[Cat-a-Tonic]

Lately I've been getting constant headaches & migraines, and have tried taking tylenol (acetaminophen), since I know I'm supposed to avoid ibuprofen & aspirin and probably other things too.

But I have two problems with tylenol - for one thing, it either barely works or doesn't work at all. And for another thing, if I take it on an empty stomach, it causes essentially a "mini-flare" with d, pain and cramps for several days afterwards. So it's really not even worth it to me to take tylenol anymore, and lately I've just been doing other non-medication-type things to try to get my headaches under control (keeping hydrated, getting enough sleep, looking away from my computer monitor regularly, etc). But that is hit-or-miss too.

Is there anything non-prescription that I can take besides tylenol for headaches/migraines? Or if there is a good prescription medicine that isn't irritating to the digestive system, what's the name of it so I can ask my doctor about it? Thanks everybody.

 

[Regular Joe]

Glad you asked.

There is hope. If you can find one in your area, get a neurologist who specializes in headache medicine. There is a specialty department at the Cleveland Clinic.

I take Axert for the migraines when they hit, which has been much less.

I take Lyrica daily as a migraine prophelactic (preventative). 150 mg worked to stave off 8-10 debilitating migraines per month. I get one now every 2-3 months. My neurologist upped the Lyrica dosage to 300mg (150mg twice daily morning and afternoon) to deter the depression and anxiety associated with Crohn's disease. I had a phone consult with my GI about this and he totally agreed. He also said that Lyrica is also known to ease Crohn's cramping and IBS spasms, so he recommended that I follow the neurologist's recommendations while taking Entocort.

Also, another first-line migraine prophylactic is using a beta-blocker. I use Nadolol. Both Nadolol and Lyrica work synergistically to also reduce anxiety and depression. This was directly from the neurologist.

And it works for me. Upping the dose of Lyrica has definitely reduced anxiety and depression. Crohn's is pretty complicated, but as I discovered, I'm able to treat both migraines, Crohn's symptoms (cramps, anxiety, and depression), and IBS spasms from the same medicine.

I use Lyrica because of past kidney stone problems. If you've never had kidney stones, then you also can use Topomax and Neurotin which act as migraine prophylactics. To stop the migraine pain, you need to get a prescription for one of several "Triptan therapies". These include Imatrex, Relpax, Axert, and Amerge, and others.

For me, I became tolerant to Imatrex and after a year got rebound migraines. But Imatrex is now available in generic form, so if it works for you, it's probably the cheapest route. I switched to Relpax which works excellent, but it knocks me out for several hours. I now use Axert which isn't as strong and I sometimes need to double up with bad migraines, but it allows me to stay awake with little to no side effects.

Here's a link to a good resource chart from WebMD: http://www.webmd.com/migraines-headaches/guide/migraine-treatment

BIGGIE here, if you have Coronary Artery Disease (CAD), you can't take Triptans unless you're cleared by a neurologist and your cardiologist. They can bring on a heart attack if you have CAD.

 

[mwb3779]

Do you use the rapid release stuff? If you don't, try that follow directions and drink a nutritional drink with it. It'll help. I was used to taking 3 alieve and now I just take 2 extra strength rapid release tylenol. I hope you get to feeling better soon.

 

[HeatherMN]

Imitrex works for my migraines. You take it as soon as one starts and can take another within a couple hours if no relief. I haven't noticed any gut problems when taking it either. There is also a preventative one called Treximet, taken on a regular basis to keep from having migraines. Both are RX only. OTC, I know of nothing other than Excedrin Migraine some people have luck with.
Between my fibro, Crohn's, migraines etc, taking Tylenol is about as effective as swallowing a couple of M&M's!
Edited here: if you are taking certain anti-depressants you need to watch for seretonin overload with migraine meds. Your dr should be able to explain that to you as well.

 

[HeatherMN]

More, staying hydrated, eating on a regular basis and getting enough sleep (all those things so easy for people other than us...) will also keep headaches or migraines at bay. My massage therapist told me those are some of the only things we have control over anyway.

 

[David in Seattle]

Lately I've been getting constant headaches & migraines, and have tried taking Tylenol (acetaminophen), since I know I'm supposed to avoid ibuprofen & aspirin and probably other things too.

You may be having rebound headaches. Ironically, most any medication you take for your migraines, including OTC's like Tylenol, can cause rebound. Here's a good article on the problem.

Caffeine is also a major cause of rebound headaches. If you have this problem, you should consume NO caffeine.

I get a handful of migraines/year, and take Zomig (a triptan). I used to take it with Naproxen, the 2 worked very well together, but as you said, NSAID's are to be avoided. In terms of prophylaxis, I tried the beta blocker propranolol years ago, but it didn't help in my case.

The suggestion to see a neurologist is a good one. Ironically, if they suspect you may be having rebound headaches & need to be weened off some medication, they may give you the dreaded prednisone for the process!

HTH

 

[Cat-a-Tonic]

Regular Joe: Thank you, your replies to threads are always so long and full of information. It's very helpful! I have been having non-migraine headaches probably 4 or 5 days out of every week, and I get a full-blown migraine about once a month. So not the 8-10 migraines a month that you said you had, but still more than I used to have (I developed my gut problems in October 2009, and the headaches/migraines started happening shortly thereafter. I never had migraines until about 8 months ago, now it's a regular thing, which is why I think it's related to my gut problems). I don't have kidney stones or CAD so that's not a concern. I will do some research on the medications you wrote about and I'll ask my doctor (don't have a neurologist, but I'll ask my GI if he could refer me).

Mike: No, I use the "Extra Strength EZ tabs tablets". Sometimes at night I'll try to take an acetaminophen PM (not sure if that's rapid relase or not, I'm at work and don't have that bottle with me). Both of those cause me days of pain & d if I take even two tablets on an empty stomach. I'll try the rapid release kind and see if that makes a difference, and I'll try drinking an Ensure with it to see if that stops the problems that I get with an empty stomach.

Heather: I'm avoiding Excedrin because that contains caffeine and I don't do well with caffeine, so I'll look into Imitrex. I'm not on anti-depressants so no worries there. And I certainly do try to get enough sleep, eat regularly, stay hydrated etc but it's sometimes downright impossible to do those things (as I'm sure we all know!).

David: I haven't taken anything for my last few headaches, and haven't noticed much difference in frequency or length or severity of headache, so I don't think I'm having rebound headaches (unless they continue to happen for awhile? It's been about 2 or 3 weeks since I've had any tylenol). As I said to Heather, I am avoiding all caffeine, so that's not the cause of the headaches. I'm not on any medications so don't need to be weaned off of anything, and I've actually never even been on pred yet (no diagnosis yet, and my GI is reluctant to prescribe anything until he has a better idea of what I've got - he thinks crohn's, but my blood tests, colonoscopy, and biopsies all came back normal, so now I'm saving my pennies so I can get a CT scan or pill cam). Since I'm not on any medications, do you think my headaches could be malnutrition-based? I take a multivitamin every day and calcium and a few others (D, B12) so I think I'm getting enough vitamins, but who knows. This response is way too long now so I'm going to sign off! Thanks again everyone for your responses!

 

[Cat-a-Tonic]

One more thing I just noticed - it's been cloudy here all day, and within the last hour a storm has been slowly blowing in. As the storm rolled in, I noticed my head started to feel worse. So the weather seems to have something to do with my headaches as well. Maybe my gut problems have made me more sensitive to changes in weather? Is that possible?

 

[David in Seattle]

One more thing I just noticed - it's been cloudy here all day, and within the last hour a storm has been slowly blowing in. As the storm rolled in, I noticed my head started to feel worse. So the weather seems to have something to do with my headaches as well. Maybe my gut problems have made me more sensitive to changes in weather? Is that possible?

Haven't read this but you might find it interesting barometric-pressure-headache. Try searching "barometric pressure headache" for more.

 

[Nyx]

I get pressure headaches all the time. When I lived out west and the chinooks rolled in, it was torture. Now, back in Ontario, I can always predict when a storm is coming as I always get a severe headache.

 

[HeatherMN]

Oh for sure! There are a few of us here at work who get headaches from the pressure changes. I used to think it was weird when I only knew of it happening to myself, now, not as much!

 

[Mayflower537]

You may be having rebound headaches. Ironically, most any medication you take for your migraines, including OTC's like Tylenol, can cause rebound.

How do you know if you're having rebound headaches or if you are just having frequent migraines? Stop taking so much medicine and see if it helps?

My husband (not a Crohnie) has had success with Maxalt, but it's really expensive. When we don't have that around, he tends to pop an Excedrin Migraine pill every time he feels a headache coming on which is sometimes a few times a week. So I've wondered about the rebound phenomenon with him...

 

[David in Seattle]

How do you know if you're having rebound headaches or if you are just having frequent migraines? Stop taking so much medicine and see if it helps?

My husband (not a Crohnie) has had success with Maxalt, but it's really expensive. When we don't have that around, he tends to pop an Excedrin Migraine pill every time he feels a headache coming on which is sometimes a few times a week. So I've wondered about the rebound phenomenon with him...

I think it is possible he's having an increased number of headaches due to rebound. In addition to the drugs, OTC & otherwise, it's generally suggested people avoid all caffeine. There's a lot of information about this online, such as the link I posted above, which your husband might find useful.

 

[Mayflower537]

Yeah, I read that article. I think you had posted it on another thread. That was really informative and I relayed the info to him. Not sure if he'll cut out his one cup of coffee a day, though... but he seems to have been willing to cut back on the Excedrins. So we'll see what happens.

 

[Cat-a-Tonic]

I set up an appointment in July to see my GI, so I'm going to ask him then about the migraines then and see what he says, and if he can write me a prescription for something or if he can refer me to a neurologist or what. I'm going to try not to take any tylenol between now and then so I'll be sure that it's not rebound headaches, and I haven't had caffeine in ages so that's no problem either.

For those (Nyx, Heather) who get the barometric pressure headaches, how far in advance does your headache start? It's supposed to thunderstorm big-time here tomorrow and I've already got a little start of a headache, not sure if it's related to the impending storm or not.

 

[GoJohnnyGo]

I occasionally have headaches. Sometimes rubbing an analgesic creme on the forehead, temples, back neck or behind the ears helps. Back when I had a shaved head, I'd rub my whole scalp with it.

Vicks, Tiger Balm, Ben-Gay, Rub A535. All seemed to be helpful.

 

[Pirate]

I use to suffer from any where from 6 to 10 migraines a month. I didn't want to take any more meds because of everything I was taking for the Crohns. My wife finally talked me into going to a quack-o-practor. when he took x-rays of my spine we found that my spine from the shoulder blades to the top was about 3 inches out of alignment.
A lot of it was due to the Crohns because of the fact I had been losing so much wieght that it was like having an 18 lb bowling ball sitting on top of a weakened spine. He even taught my wife how to stretch my neck when I got a migraine. This all happened over 15 yrs ago and now I may get 1 a year. And that one is no where near as intense as they were.
I know that migraines can be caused by many things, but this is just another suggestion to think about. Good luck.

 

[Cat-a-Tonic]

Interesting, Pirate. I try to get regular massages but I've never been to a chiropractor. My massage therapist has said that my spine does seem to have a little bit of a curve in it, but he didn't seem to think it was anything to worry about. Maybe it is worth getting a second opinion from a chiropractor, though. It's weird to me because the frequent headaches and the migraines only just began when my gut symptoms did, so I would think it's gut-related and not spine-related, but who knows. I have lost some weight, as you said was part of the cause of your migraines, so that might be it for me too. (I have lost about 15 lbs, but that's fairly significant for me because I'm thin to begin with - I was 135 lbs before I got sick, now I'm at about 120 and I'm fairly tall for a female.) Thanks for the info, I will check to see if my insurance will cover a chiropractor visit.

 

[Sue-2009]

Dave--why no caffeine? S