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.