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If you read the last couple posts, you'll remember me mentioning something about stomach flu. Well, it came back with a vengeance last night. This is a really strange "stomach flu," and it has me concerned that it might not be viral-- since it has lasted more than 24 hours. This means that it could be bacterial in nature, something more systemic, or maybe even related to my current dosage of Topamax. I'm considering dropping down to my previous dosage of Topamax to see if that makes the stomach cramps go away.

Anyway, for those of you that really want to know, the symptoms are: within 5 to 30 minutes after eating, moderate to severe lower gastric stomach cramps. Trying to go to the bathroom is generally unproductive. These are generally accompanied by a mild fever (99.8, though I spiked at 103 in Florida) and chills. Maybe this is why those of us on Topamax sometimes lose weight?

Good Comment to Read

I know that not everyone reads the comments to posts, so I wanted to direct your attention here. I promised to address a couple of points directly in the blog so they didn't get lost, so here they are:


Q: I see you have tried many a migraine drug – have you tried Naramig? Its a Glaxo drug.

However, sometimes it doesn’t work. I am yet to find out whether the failure is because I have left it too late into the headache before I take a tablet, or if the headache is just too strong.

Q: Actually, I’d appreciate your opinion on this – why do you think some medications fail when other times the same medication works wonders?


Naramig isn't one of the drugs that I've tried (or even heard of). However, doing some quick research, it looks like Naramig is another variant of the triptans (Naratriptan). Looks like it might be more popular on the other sides of the pond from me, as I see most of the websites are .co.uk and .au websites that talk about it. Here's my personal epxerience with triptan use . . .

I personally love my Maxalt, becaus, like you say in your comments, triptans do a great job making migraines go away. The trick with triptans, for me, though is not to wait too long. If I get to a point where its a "pounder," I'm generally lost. It is almost like the neurochemical effect of the migraine is gone, and the phsiological effect is upon me-- in essence, that which the triptan can fix has gone away, and that which only time and painkillers can help has arrived.

Q: Its my understanding that Naramig (being a beta blocker) works by restricting the nerve ‘tunnels’, so that the pain nerves can’t get through is this correct? Or is it more correct that it restricts the blood vessels? I should look that up myself actually. I should know how the thing actually works.

Remembering that "Rob is not a doctor," nor am I a scientist, here's my understanding of Naramig based on the description from netdoctor.co.uk and other reading about migraines.

Naratriptan is a serotonin agonist. "Agonist" means that it basically makes serotonin work better in the brain. Serotonin acts as both a neurotransmitter (sending signals from one part of the brain to another) as well as a vasoconstrictor. Since the triptans act on serotonin (which is primarily in the brain), and they act as a vasoconstrictor, what you get is a localized constriction of blood vessels in the brain. What this seems to do is help remove pressure on some key nerves in the brain, such as the trigeminal nerve, which is believed to cause migraines.

So, if you've got vasodilation happening at the onset of a migraine, perhaps even before the pain starts, and you can get a vasoconstrictor in you early, you might be able to ward off the migraine. Wait too long, and the trigeminal nerve has been stimulated too much by those nasty blood vessels, and the damage is already done, and you're in pain mode for a while, it seems. The triptans are nice because the vasoconstriction can get localized to the brain instead of being systemic. At least that's my limited understanding of it.