Fair warning: today’s post is more medically informative than my usual reflections—it’s still personal, but a bit heavier on the details than you’re accustomed to here, and I suspect this medication may also make me a bit loquacious, as Susan could probably attest after our conversation last night.
It’s not often that I wake up and still feel this sleepy. I have a migraine medication that I rarely take because it can make me drowsy for a couple of days. Most of my other medications work fine, so I tend to avoid the ones that linger like that. I think this morning’s drowsiness is also due to a migraine medication.
At my last appointment at the Headache Clinic, they gave me a new medication to try. It’s one of the newer CGRP medications. I’ve tried several over the years. This one is interesting because it can be used as a rescue drug, though some CGRP medications are used as preventatives.
I take Qulipta daily as a preventative. Ubrelvy, however, is a rescue medication. Most CGRP medications are taken once a month, once every three months, or daily. Ubrelvy isn’t taken that way. It’s meant to be taken at the first sign of a migraine—usually an aura.
Auras look different for everyone, but they’re a signal that a migraine attack is imminent. For me, my auras are small twinkling lights that float in my vision. They aren’t dramatic, and they rarely last more than a few seconds—never more than 30 seconds. I don’t always see an aura before a migraine, but if I do see one, I will get a migraine.
So instead of taking it at the beginning of the headache itself, as with most triptans, Ubrelvy is taken when the aura appears.
Yesterday, I saw an aura and took a dose of Ubrelvy. I never developed the migraine. That alone feels like a victory.
Ubrelvy has three potential—though still somewhat rare—side effects: nausea, sleepiness, and fatigue. Most people experience side effects within 30 minutes to an hour after taking a medication. However, because of my liver issues, medications can take longer to become effective or for side effects to appear. Some medicines, including Ubrelvy, are metabolized in the liver. When liver function is compromised, metabolism can slow down, which can delay both effectiveness and side effects.
That seems to be what happened with this dose.
About three to four hours after seeing the aura and taking the medication, I became very drowsy and fell asleep in the middle of reading a book. It took me a bit to fully wake up, but once I did, I seemed fine. Then last night, the drowsiness hit again. I fell asleep early and slept through the night—even through Isabella’s usual insistence on being fed.
I woke up at 4:00 a.m. when she made her presence known, but I went back to sleep. When I woke again around 4:30, I checked the time and made myself get up, feed her, and put on some coffee.
I’m awake now, but I could very easily lie back down and fall asleep again—even after being up for an hour.
I’m hoping this doesn’t last all day. I’ll drink my coffee, watch the news, and take a shower—all of which should help me wake up more fully. I was out of work Monday with a migraine, off yesterday, and I have an important meeting at 9:00 a.m., so I really need to be at work today. If this drowsiness continues, it may not be a full workday—but hopefully I’ll shake it off and get through.
I’ll likely make a strong cup of tea when I get to work this morning.
To make up for how boring this post may have been, here’s Isabella’s Pic of the Week (with a little bit of me thrown in the mix):
6 comments:
Try reducing the amount of Ubrevly to see if it is still effective yet with a milder side effect. Coffee!!!!
Yes, coffee is better for staying awake.
COFFEE, RED WINE, SUGAR PRODUCTS are poison for folk with migraines . Have a cousin & sister in-law who have been suffering from them since their early twenties. So they have been missing out on the fun things to consume.
William NS
When I was experiencing migraines (long ago), my doc gave me a medication called Esgic. I think caffeine and butalbarbital. Take it when the aura appears. I had some success with it.
Are these emergency medications oral or a shot? A shot would bypass the liver?
Also, if I drink a coke when the auras appear, that also helps.
I know everyone says that caffeine and chocolate are bad for migraines, but that’s not the case for me. Usually, when I have a migraine, they actually help. In fact, if I crave chocolate during a migraine and eat some, it often goes away. I don’t crave chocolate often, so when I do, it seems to mean something. As RB noted, caffeine has long been a component of migraine medications. I used to take Bupap (butalbital/acetaminophen), but doctors now generally prefer that migraine sufferers avoid barbiturates.
RB, the emergency medications typically come only in pill form or oral disintegrating tablets (ODTs). I can’t tolerate ODTs because they usually contain artificial sweeteners, which are a migraine trigger for me. Some of the CGRP drugs are available as monthly injectables, but those are preventive medications rather than rescue treatments.
Imitrex, one of the triptans, was once commonly kept in injectable form in emergency rooms for severe migraines. It was the first of the triptans, and at one time you had to go to the ER to receive the shot. It also comes in pill, ODT, and nasal spray forms. To my knowledge, most other rescue medications are not available as injectables.
The one time I had to go to the ER for a migraine, I was given an IV of Toradol. I’ve also received Toradol injections at my doctor’s office for migraines that wouldn’t respond to other treatments. As for Imitrex, I cannot tolerate it. When I was under intense stress while teaching in Alabama, I frequently had level 10 headaches (on a 1–10 scale, with 10 being the worst pain imaginable). My doctor prescribed Imitrex once, and instead of helping, it had the opposite effect. On that same scale, it felt like a level 15. That was the only time I’ve ever been on the floor crying in pain, honestly hoping it might kill me just to make the pain stop. Eventually, it did subside, but I have never taken Imitrex again.
None of the other triptans have caused that extreme reaction for me, though some can create a sensation that feels like you’re having a heart attack when you take them.
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