Posted on 06/05/2014 6:49:38 PM PDT by Seizethecarp
I had vertigo once and it was a hardened ball of wax. They dissolved and drai.ed and it went away.
Thanks, LucyT.
I would hate to think that even one FReeper would suffer needlessly like I did not knowing that there was a drug that could cure “vestibular migraine” if that was the cause of their dizziness, as it was in my case.
GLAD TO HEAR YOU’RE SO MUCH BETTER!
You really need a new neurologist, if yours truly did not recognize migraine as a possibility.
There’s a calcium channel blocker called verapamil that, taken once a day, is a splendid preventive for basilar or vestibular migraine. Generic, no side effects, $6 a month.
After months of CAT scans, MRIs, visits to the ENT and cardiologist, I finally was referred to a good neurologist who diagnosed the condition in 5 minutes.
“Shoot-me-and-get-it-over-with” attacks had consistenty been a week or two apart, seriously affecting quality of life. Now there are one or two episodes a year, and generic Antivert (meclizine, over the counter, 90 for $6) at onset reduces their severity so I feel fine the next day.
Great news... thanks for sharing.
“You really need a new neurologist, if yours truly did not recognize migraine as a possibility.
“There’s a calcium channel blocker called verapamil that, taken once a day, is a splendid preventive for basilar or vestibular migraine. Generic, no side effects, $6 a month.”
I’m sorry, but you are providing possibly misleading medical advice based on your personal anecdotal experience to FReepers.
Yes, I have provided my anecdotal personal tale but I have told FReepers to go to their MDs and as support I have cited to FReepers the same recent (2012) peer-reviewed evidence-based reaserch that persuaded my neurologist to prescribe topiramate (Topamax) for me in the American Academy of Neurology article “Evidence based guideline update: Pharmacologic treatment for migraine prevention in adults”:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335452/
Considering myself to be open-minded I looked up your recommendation of Verapamil and found that according to this comprehensive evaluation it not as conclusively ineffective as the drug that my neurologist had first recommened that I take for migraine, which was lamotrigine (Lamictal) but there was “inadequate or conflicting evidence to support or refute use” of Verapamil for migraine.
Here is an image of all the comparison of all of the drugs in the Neurology study
Well, never mind.
When I read your post last night, I actually felt compassion and gave you a break. Perhaps your unrelenting arrogance and abrasiveness on FR was because you were a sick old grump. Your statement of “Considering myself to be open-minded. . . “ was my first laugh of the day, because you may truly be the most didactic and overbearing poster on FR. Finally, you had an excuse!
My post was meant to help. I said no more than what you did: here’s an effective treatment, it worked for me, see a neurologist. The term “migraine” covers a broad area. It is not a well-understood illness. What works for one may not for another. Verapamil, however, is a proven treatment.
From the Journal of the American Medical Association: http://jama.jamanetwork.com/article.aspx?articleid=388597
From the Official Journal of the American Academy of Neurology: http://www.neurology.org/content/34/7/973.short
I am well today. And happy. My hope for you is that your persuasive snarkiness stems not from your illness but rather a character defect and that you will continue to heal.
Sorry, your two articles on Verapamil are general and from 1983 and 1984 while my comprehensive survey of evidence-based treatments published by the American Academy of Neurology specifically on treatment of migraine for adults is from 2012. My article says that Verapamil has NO conclusive evidence-based support as treatment for migraine while Topamax has substantial evidence based support.
FReepers can draw their own conclusions between the two of us regarding credibility.
“I was amazed to read that the association of this type of migraine with debilitating vestibular balance impairment was considered “common” because neither my PCP nor my neurologist nor my ENT had suggested this diagnosis to me as an explanation for my symptoms.”
P.S.:
As I am reading more about this topic and looking back I can see that my neurologist suspected that I might have had migraine as months back she began to try me out on a series of anti-depressants in very low doses that are either off-label used for migraine or were formerly thought to work before the 2012 evidence-based American Academy of Neurology article that I posted came out. She just didn’t mention that she suspected migraine.
My reaction was to be mostly offended that she was insinuating that I was “depressed” rather than having a “real’ symptom.
She also needed to hold back on going conclusively with a migraine diagnosis until the results of the EEG and inner ear MRI that had been ordered by the ENT MD came back to in insure that I wasn’t having seizures and didn’t have a tumor on my inner ear nerve respectively.
So only having completed the differential diagnosis of exclusion and then seeing the very positive response to the initial dosing of the Topamax was it good for her to be confident to titrate me up more as she is doing now.
You are absolutely correct, as always. Verapamil is an old drug, used for years, proven but not fancy or with weird side effects. It restored my quality of life.
Thank God I didn’t think I knew more than my neurologist, or I too might have been taking a drug that makes me dopey and confused. Your words, not mine.
And I was wrong to suggest you need a better neurologist.
It’s obvious that all you need is a doctor who will follow your superior understanding of virtually everything. Sometimes it takes a “mostly offended” patient who preaches to a doctor about his own “comprehensive survey” and self-diagnosis to get that doc to do his bidding. It’s good that your symptoms abated long enough “to rush down to my neurologist and persuade her to prescribe topiramate for me instead of her choice.”
Did you have to threaten her?
I first read this thread last night and was genuinely happy that your vertigo has lessened. I know first-hand how terrible it can be. I’m also glad that you feel better.
Perhaps now you can do some research on meds to alleviate arrogance.
“Did you have to threaten her?”
By pure dumb luck I happened to stumble on a very recent evidence-based review of migraine treatments in the most highly regarded publication in her profession.
I printed out the table that I linked to in the thread above and put it under her nose of commonly prescribed migraine meds habitually prescribed by neurologists including Verapamil, and the one she favored, lamictal and the one that came tops in the evidence-based science, Topamax.
What she was threatened with was self-condemnation...condemnation of herself by herself if she persisted in selecting an inferior drug for her patient sitting in front of her...rather than a drug recommended by her own professional journal. She chose the drug recommended as proved by evidence-based science to be effective over the one that she had previously been prescribing. Bless her!
Verapamil is a blood pressure lowering drug. My migraines are totally UNCONNECTED with my blood pressure, which I have conclusively proved with extensive charting over time with my home blood pressure cuff. My blood pressure is low and controlled by losartan with no effect on my migraines.
“As it happens there is an off-patent drug, topiramate (Topamax) that has been shown in “evidence-based” peer-reviewed trials to be effective for migraine and so I was able to rush to down to my neurologist and persuade her to prescribe topiramate for me instead of her choice. I happened to have a copy of a Journal of Neurology article that supported my selection and to her credit she deferred to the recommendation in that article for the topiramate.”
P.S. I want to add this comment to expand on why my neurologist so readily deferred to an “evidence-based” peer-reviewed drug selection. Some FReepers might not be as familiar with this professional lingo as medical and other scientists are.
Here is a Wiki link which explains that “Evidence-based practice” is a well-established movement across many fields of medicine meant to correct sloppy former practice of medicine by habit under pressure from big pharma reps in short skirts or kickbacks or the placebo effect or “we always prescribes this pill for that”
When I showed up in my neurologists office with a recent 2012 survey from the American Academy of Neurology detailing their strict evidence-based criteria as applied to magraine medication, she deferred to the best judgment of her profession and of this well-established quality control methodology...which I just happened to bring through the door to her on that day through dumb luck between debilitating migraines.
http://en.wikipedia.org/wiki/Evidence-based_practice
“Evidence-based practice (EBP) is an interdisciplinary approach to clinical practice that has been gaining ground following its formal introduction in 1992. It started in medicine as evidence-based medicine (EBM) and spread to other fields such as dentistry, nursing, psychology, education, library and information science and other fields. Its basic principles are that all practical decisions made should 1) be based on research studies and 2) that these research studies are selected and interpreted according to some specific norms characteristic for EBP. Typically such norms disregard theoretical and qualitative studies and consider quantitative studies according to a narrow set of criteria of what counts as evidence. If such a narrow set of methodological criteria are not applied, it is better instead just to speak of research based practice.[1]
“Evidence-based behavioral practice (EBBP) “entails making decisions about how to promote health or provide care by integrating the best available evidence with practitioner expertise and other resources, and with the characteristics, state, needs, values and preferences of those who will be affected. This is done in a manner that is compatible with the environmental and organizational context. Evidence is comprised of research findings derived from the systematic collection of data through observation and experiment and the formulation of questions and testing of hypotheses”.[2]
“Empirically supported treatments (ESTs) are defined as “clearly specified psychological treatments shown to be efficacious in controlled research with a delineated population” [3]”
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