Gifted Issues Discussion homepage Forums Twice Exceptional Afraid to take medication

When my son went to the neurologist about his migraine headaches he was given a prescription for Imitrex. The pharmacist at the base pharmacy refused to fill the prescription because my son is only 12 and the pharmacist thought he needed to try other medications first.

When we went back to the neurologist he prescribed Amitryptyline to prevent the migraines and he said it should also help with my son's leg pain at night.

My son and I already have a problem with trusting doctors after some things happened in my family, like my mother going in for a routine surgery and coming out with severe memory loss and unable to care for herself. She was only 64. They say there can be "complications" with any surgery. The complications in this case totally devastated my family. Instead of enjoying his retirement years, my dad has taken care of my mother for over seven years. He can't go anywhere because it is hard to find a caregiver that will change adult diapers. A nursing home would be too expensive at $4000 a month. I live next door and my son and I take care of my mother when my dad has to go anywhere so we are a little more aware of possible complications than a lot of people. Some of the medications my mother took afterward had really bad side effects and my son saw all of this. It is hard to put this out of our minds.

Amitryptyline has some really scary possible side effects. We were told he can't take aspirin because there is a chance of getting Reyes syndrome and he can't take Ibuprofin or Tylenol every day. My son read about the possible side effects and he says he doesn't want to risk taking the medication. He would rather live with some pain as he has been doing for years. When he is older he will be able to take over the counter migraine medication that I think is safer. My husband wants him to try the Amitryptyline because my son has so much trouble sleeping and the neurologist said it might help him sleep even though I read that it can make restless legs worse and my son has restless legs like I do.

Should I make my son take the medication? I can't help but think of my mother telling me about her bad feeling about having the surgery and I didn't really listen and told her everything would be fine.

I would and have asked the pharmacist for their advice. They know about medications. Ask the same pharmacist what they would recommend that works with the mildest side-effects. I've even had the pharmacist call the doctor when I didn't like the side effects listed on the warning labels for a prescription and decide between them the safest alternative.

My approach would be to do more research and make sure there are really no other choices than be in pain or take a powerful antidepressant. In non-crisis situations it makes sense to start with the least dangerous interventions and work from there. Less dangerous approaches might include: magnesium and iron supplementation, eliminating caffeine, working on a very regulated schedule with time every day for exercise, working on sleep hygiene like having screen free time for at least two hours before bed, biofeedback, talk therapy to work on better stress management, keeping a journal to look at food or other lifestyle triggers, getting a sleep study to get a clearer idea what is going on with his sleep, etc.

As far as the fear of medication, I would attempt to encourage more critical thinking about it. If he's regularly taking Motrin he's already doing something dangerous. The fact that something is over the counter doesn't make it safe and the fact that something is prescription doesn't make it dangerous. As a person sensitive to medication I've developed some approaches that work for me. The first is as I said about to research and implement lifestyle changes as they often are as effective as prescription medication. If I feel I need to take a prescription and there are choices I prefer a medication that has been on the market longer so there is more of a track record. One good thing if he decides to take this medication is that tricyclic antidepressants have been around for a long time so there has been plenty of research. Also, they are typically prescribed with very low starting doses and that would be one of my suggestions for medication sensitive people is to see if they can try a smaller dose as a start. When you are looking at the side effects you may want to explore with the pharmacist if these are more likely at higher doses. If he does decide to take the tricyclic it would be a good idea to keep a very close eye on weight gain.

Does your son know his triggers for migraine?

Did he try to take some caffeine at the onset of migraine?

I have pretty bad migraines (though not as bad as some people), and I have tried amitryptyline. My doctor told me that it was such a small dose that I would not have side effects. That was not true for me. It was actually probably the worst period of my life, because I had a very profound reaction, which is that I could not sleep. I got (literally) no more than one or two hours of sleep a night for the couple of months I took it (and even the sleeping pills that my doc then prescribed, because she did not believe that it was the amitryptyline, did not help). Now, I'm not saying that your son is likely to have that reaction, or any serious reaction. But the lesson that I took from my experience is that "prophylactic" long-term medication will be absolutely the last strategy I will employ.

I agree with the others that avoiding triggers is the best strategy. For me, having a strict caffeine schedule (only one cup of tea in the AM) gets me down to only one or two migraines a month. If I pay attention and take OTC pain meds immediately when I feel a migraine coming on, it'll usually nip it in the bud. I usually take both acetaminophen and ibuprofen together, which is fine if you're only taking it once in a while. If I wait until I'm actually in pain, OTC meds won't help at all no matter how much I take.

That said, I also want to ask how often he is having these headaches. Your post makes it sound like they are daily, but if they are daily, they're not likely to be migraines.

Does he eat a lot of chicken, and if so, does he have a migraine after? I know this sounds silly, but chicken has been known to cause migraines. Pork can as well. Watch the diet and see.

Also, I have an issue with my spine, and when it flares, I get migraine like symptoms... I know people don't always agree on chiropractors, but a simple adjustment makes a WORLD of difference.

Giving any medicine is really scary, especially when they are kids. Good luck in your decision.

I understand his fear. Seeing first hand what can happen with complications who wouldn't be fearful? If he doesn't want to take the medication I wouldn't push him. He knows his pain threshold and what he can live with and from what you have written in the past about him he seems to be a very mature boy.

DS22 (the son I rarely mention [:P]) was tested to have a latent version of a potentially serious/fatal disease. It was the kind of thing where 9 times out of 10, he would never develop the actual disease, but in the event that he did, he would be quite ill and loaded down on drugs. Anyway, to get rid of the Latent bacteria, he was supposed to take a medication for 9 months. This medication left a risk for liver problems, so he had to get checked out for that very frequently. He was *extremely* reluctant to take the medication, though he eventually did, and he turned out fine. He is still a wreck about medications, though, I don't think his "success" made anything better as far as not being nervous in the future goes. I also hope he doesn't find out about the recent linking of Accutane to abdominal illness, I don't know how I ever convinced him of taking that in the first place, I guess he knew his acne was incredibly severe, though. The same son also suffered from migraines and didn't get treatment, they eventually stopped happening as frequently around when he turned 20. I imagine your son's situation is worse, though.

I know that doesn't help you too much, but I do find it interesting that our family went through a similar situation. I don't think you should try to force him into taking it, but getting statistics from a doctor on the prevalence of the side effects would definitely calm 2 of my 3 medication-scared children, and if the risk is too high for comfort, like others said, maybe you can try to find an alternative medicine.
Anyway, good luck with everything, I know how difficult it can be to see your children suffering but afraid of the only thing that could make it better.

I think, in general, doctors always try to figure out the best solutions for patients, although this can be tricky as each patient is unique and they only have published studies of large groups and their own experience to help them make decisions. Then again, I think it is always important not to treat what a physician says as the word of God. Do as much research as you can and try to form your own opinions based both on what you learn on your own as well as what your doctor says. Personally, I would put more weight in what a neurologist says than a pharmacist based on the amount of education and training a neurologist has in his speciality. However, if you're not sure of what the neurologist is telling you, I'd absolutely go to another neurologist for a second opinion, or a third opinion, or maybe even seek out a headache specialist.

I agree with others, too, that it might be worth trying some other approaches. I don't know how often your DS gets migraines, but I have had migraines since I was 6 and my DS12 gets them a few times a month. There are a few things we use that are non-medication, although certainly we still need medication (usually Tylenol or Motrin, taken as early on in the headache as possible). We swear by moist heat, specifically in the form of a "Bed Buddy", which is a sock-like heating pad that you heat up in the microwave. I find that it works best to put it on my eyes and the bridge of my nose, although sometimes it feels best on my neck. Other people, though, like cold better than heat, and the Bed Buddy can be used for that also. (You can find the BB at Walgreens and it's pretty cheap.). Another thing that works for me is to put pressure on the bridge of my nose, usually by laying my arm across it while I shield my eyes from light. I have heard that pinching the fleshy area between your thumb and forefinger works for the sometimes-accompanying nausea. We also have found moderate success with a peppermint oil product that we found at Bath and Body Works specifically made for headaches. I rub that on my temples and my neck and my sinuses and that offers a little relief. Caffeine can be beneficial as well, so I'll often drink a coke or other caffeinated drink as soon as I feel a migraine coming on. Excedrin is supposed to be a good over-the-counter med for migraines precisely because it does have caffeine in it. And, while I'm sure you've heard this advice, the best thing is to lie still in a completely dark room and sleep it off, if possible. Usually, I try to hit the migraine with as many of these things as possible all at once.

And, too, avoid the common triggers of citrus, wine, chocoate, and cheese. Make sure that his sleep cycle is very regular regardless of how many hours of sleep he gets. If possible, keep him inside on very humid days, since the humidity itself can be a trigger, as well as the general heat. Make sure he is not getting dehydrated during the day. And sometimes vigorous exercise can be a trigger so you might want to look into that as well.

I wish you well in figuring this out.

Also, completely anecdotally, I have heard that placing a bar of soap under the sheets by your feet can help with restless leg syndrome. Don't know why it would work or if it actually does, and it sounds pretty crazy, but it's basically free and might be worth trying for a few nights.

My ds10 also has migraines. He takes ibuprophen at the onset (and every 4 hours after) and zophran for nausea (which he does not have with every migraine anymore. I'm living for the day he can take imetrex (he has to be 12). He has taken cyproheptadine (pericactin) with no results, and topamax with some positive results and some negative. The topamax lessened the duration and severity of the migraines but had no effect on the frequency. It made him a little spacey (but he has ADHD, so it's a subtle thing). Right now, he's not taking any daily medicine for migraines, but he probably will once school starts again.

We have not found a food trigger, but getting too hungry can be one. Also, not enough sleep, deydration, and getting too hot can be problems, as well as stress.

As the OP will know, a child under 16 cannot take Excedrin because it contains asprin. I'd be happy to try caffeine at the onset, but ds doesn't drink anything that contains caffeine (other than hot chocolate or chocolate milk, but chocolate can be a trigger for some people). I've tried to get him to develop a taste for tea, but no luck yet. He won't drink anything carbonated.

But enough about me...
Are you seeing a pediatric neurolgist? The doctor ought to be willing to discuss the side effects with your son. I didn't want to go with daily medications either, but when things get bad enough, you try things. Ds used to be hysterical when he knew a migraine was coming (he started having them at 2 but was not properly diagnosed until 5).

We use a herbal remedy called "restful legs" that we get at Walgreens. They look like saccarin, taste like chalk and they work. Have no idea why but there are two sufferers in my house and they work well.

Thanks everyone. I have been so sleep deprived that I can't think straight and I didn't know what to do. My son sleeps until noon when he can't sleep but I have to get up early. We need to start back with our homeschooling and this is going to be hard if I am too tired to think and he is sleeping until noon. We have to do something. I just hope there is a better alternative than that medication. I will see if I can talk to the pharmacist when I go to pick up the medication.

My son and I get migraines with weather changes and we also seem to get them whenever the temperature goes over 100 degrees. We were both getting headaches about three days a week for a while. We do use caffeine when he starts to get a headache and it helps a little.

My husband wants our son to try the Amitryptyline because it has become so hard for us to get a good night's sleep and the pediatric neurologist said it should help my son sleep. My son often wakes me up at 2, 3 or 4 in the morning because he can't sleep either because he has a headache or a leg ache or restless legs. He could be having growing pains because he is growing a lot. I will try the restful legs from Walgreens.

It looks like the Restful Legs stuff is homeopathic. May be worth trying, but if it doesn't work I would also look at the possibility of a deficiencies in magnesium or iron. Have these been tested? Many people, including one I live with, have found restless leg problems eliminated with magnesium supplementation. It is a common deficiency.

Personally I would be VERY hesitant about attributing pain to "growing pains." We heard this explanation with our son but when his metabolic problems were treated this totally went away suggesting that "growing pains" was a garbage explanation that was getting in the way of treating what was really going on. I would not see muscular pain as separate from hypotonia, but instead a flag that he may have some underlying problem that requires treatment - not just masking with an antidepressant.

As far as waking you in the night, I see that as a huge problem. Your sleep is important too. He's old enough that he should have tools to handle it if he is having problems in the night without having to disrupt your sleep as well. I would focus on helping develop some routines during the day to handle these times. It may help him to get up and walk or to use a heating pad. During the day he may practice deep breathing or relaxation exercises. Rehearsing ahead of time makes it so the body is more able to access these techniques when they are needed.

If you and your son have not already done so you may both benefit from reading more about insomnia and sleep disorders. Pretty much everything written about sleep problems emphasizes the importance of consistent routines. Sleeping in to try to make up lost sleep doesn't work and will make the problem worse the next night. This is a very academic book but your son is bright and this may be helpful to him. http://www.amazon.com/Promise-Sleep-Medicine-Connection-Happiness/dp/0440509017/ref=pd_bxgy_b_img_c

I'm no doctor so I'm not giving medical advice... Let's get that out of the way. LOL

Seriously... a friend of mine's husband had way bad migraines all through his younger years into adulthood. You know lights out, no noise, vomitting. The works. He never went on daily prescription meds or anything. Just dosed himself with massive pills when one would start.

Anyway, as an adult, he ended up going to therapy for something or other. It turns out he had been holding so much inside that he actually was causing himself to have migraines. The therapy got rid of most of the old stuff and with his new skills he is able to get those emotions out regularly. So he rarely gets migraines anymore!

Maybe something similiar could be going on with your child? I mean it couldn't hurt to take a weekly kids yoga class or do some daily meditation exercises with him. There aren't any side effects that I know of. Or maybe the kid is worried about his life. I think I read you were on base. Military? I can imagine that would put some thoughts into a kids mind. Maybe there is a support group for kids in the military?

Whatever you do listen to yourself. If you have a feeling that you should or shouldn't do something there is a reason. Explore it and you'll find your answer.

Many blessings

If he takes magnesium for his legs, it might also help with migraines. Vitamin B2 is also supposed to help some people.

Just a couple of things I'm unsure of here:

1. I don't understand why the pharmacist questioned the prescription from the neurologist. I would have thought the neurologist was in a better position to judge the type and severity of the migraine and therefore the most appropriate treatment. Based on the evidence in front of him the doctor may have felt it wasn't appropriate to try something else first.

2. Was the script for Imigran tablets or nasal spray? If it was nasal spray then it is safe for use in adolescents 12 - 17 years of age.


I'm not telling you anything new by saying that all medication has potential side effects even the ones that most people would regard as innocuous. In any given circumstance you have to weigh the pros and cons and make your judgement based on that. Why are you seeking advice from a neurologist for your son's migraines? I would imagine the answer is, because they are impacting on his ability to function normally. If this is indeed the case then do the risks of a side effect outweigh the potential for him to lessen the effect of the migraine. I don't think you can make your son take the medication, he is an intelligent young man and ultimately he will make the decision but at some point what he will have to consider is his quality of life and the impact he is having on other members of the family.

I think the first prescription, the one the pharmacist wouldn't fill, was for Imitrex tablets. I was surprised that a pharmacist would question a neurologist. My husband talked to the pharmacist that time so I don't know exactly what the pharmacist said.

By the way, the very busy AFB pharmacy that we use because our medications are free there (husband is retired military) just gave my husband the wrong medication. Who knows what it is or what potential side effects it might have. The information on the bottle said it was one thing but it looked totally different from the medication in the second bottle which was supposed to be the same thing. My husband says he knows to always check his medication before taking it because this has happened before. This is just one more reason I am a little worried about using a prescription medication for my son. If it is over the counter stuff and my son accidentally takes magnesium instead of fish oil, no big deal. But if we are given the wrong prescription medication, who knows what could happen.

My son wants to know how we are supposed to just put things like this out of our minds and trust the people in the pharmacy and the doctors prescribing the medication. He has "white coat syndrome" and his blood pressure goes up just like mine does when we have to go to the doctor. I got put on blood pressure medication that makes me tired all the time because I couldn't convince my doctor that my blood pressure wasn't high like this all the time. My blood pressure wasn't high when I was pregnant with my son and I was an older mom when I had him. Going to doctors who couldn't give me answers and not being able to get therapy for my son for his low muscle tone caused a lot of anxiety. Not being able to figure out how to get help for my son and seeing him in pain caused my blood pressure to rise. Not sleeping doesn't help either.

Now I even wonder about the headache medicine my doctor prescribed for me when I was pregnant with my son. Was I really taking what they told me I was taking? I also wasn't told anything about possible problems with having labor induced with pitocin or having the epidural. The neuropsychologist and the neurologist both said it was possible my son's hypotonia and sensory processing and other difficulties were caused by the difficult birth--possible mild birth asphyxia, slight delay in getting him out because vacuum thing wouldn't work and they had to use forceps. I know this had nothing to do with the migraines and restless legs problem because that runs in my family but he should not have to deal with the back pain and leg pain and foot pain that he gets when he tries to keep up with other kids physically because he has mild hypotonia. He will be competing with his fellow acting group members in a dance routine as part of a local parade today. He will do it, which is amazing considering he was diagnosed with motor dyspraxia, and he will probably do it well just like he did all of his performances of Seussical the Musical but he will pay for it later with leg pain and back pain. He is willing to live with some pain in order to do what he loves doing. I will massage his legs and back if he hurts tonight, just like my mom would have done when I was a child. She never got mad at me if I woke her up because I was sick or hurting.

I thought my husband would be upset when I told him that I wasn't going to force our son to take the medication. He thought about the experience he had trying to get relief for his sinus headaches. Doctors prescribed medications that did nothing for him. Someone told him about Oregano Oil. He tried it. It works for him and there are no side effects.

My son woke me up last night again. He didn't yell my name so he didn't wake up his dad. I just heard him say Mom. He knows I have trouble sleeping too and thought I might still be awake at 2:00 a.m. I was. I went to his room and his back was hurting this time. He didn't ask for pain medication because he wants to save the Ibuprofin and Tylenol for worse pain, but the back massage helped him. He finally fell asleep about 3:00 a.m.

We are going to try Restful Legs tonight. I am so hoping that this will work. If we can just get better sleep then it will be easier for us to deal with pain and there will be less anxiety and our quality of life will be so much better.

Thanks again, everyone.

Just to be clear the suggestion wasn't that you yell at him for waking you up. Rather, that one of the things that may help him ultimately feel better and less afraid is if he develops more independence and competence. ALL people feel anxiety. ALL people face difficult parts of life. Yes, some more than others and life isn't fair. But, we've all got to find a way to play the hand we were dealt without being trapped in a place of feeling like we are mistreated or hopeless.

One of the best ways to decrease anxiety is to find ways to effectively deal with moods and to feel greater control. Also, as we all know there is a huge mind body connection and unresolved anxiety can play out in chronic pain symptoms.

There will be a time when he will no longer want to rely that his only way to cope is to wake up his mom. That is not a model that allows him to develop an appropriate level of independence that will allow him to be able to have new experiences or to individuate. I would look to the future and try to explore other methods to help him develop coping strategies.

..for entertainment only:
http://www.avoidamigraine.com/migraine.html

I never got migraines. �My mom and two sisters did. �One sister controlled some of her migraines by hanging upside-down. �I googled to see how reasonable this is. �
The page I just linked has all the home remedies listed here and an alternative explanation for their origin- toxins accumulated in the spinal cord between the stomach and the brain, rather than engorged vessels inside the brain. One of the links on the side said Chinese medicine suggests the time of day the headache occurs tells us which body system is detoxing, causing the headaches. �If he's always getting them at 2am... Sadly they don't give you the chart.
Just a fun read about alternative migraine medicine. �Like I said though, talk to the doctor and the pharmacist and make sure they resolve your concerns to your satisfaction. �They have the degree and the education, that's why you hired them. �But don't forget, you're the customer. � You don't have to be rude and tell them, but keep it in your mind that they should not brush off your concerns unresolved. �You hired them to provide a service for you.

You know, with back pain and leg pain and foot pain and headaches, it really sounds to me like a chiropractor and/or an acupuncturist might be a good avenue to explore. This whole collection taken together seem like spinal alignment or nerve issues that you might be able to take care of without all the worrisome medication. Just a thought. I know your insurance doesn't likely cover those (we're on Tricare, retired military as well), so that could be a problem, but if you can swing it, it's worth a try.