SSRIs worsening my migraines - might need to stop

QUESTION AT THE END —- I have a migraine disorder and also moderate to severe OCD. A handful of months ago I made the plunge to restart medication for my OCD, and it became clear to me I REALLY needed it. I was completely dysfunctional, and medication made me semi functional and brought my OCD down to mild/moderate. The problem is, I’ve tried 2 different SSRIs so far and both helped my OCD but made my migraines so much worse. Like, daily low grade headache, every trigger is way worse, and my bad migraine episodes last weeks instead of days. I’m currently on Prozac, and I’ve been on it for just over 2 months. And I think I need to come off of it because of the migraines and I’m super worried because I’m so dysfunctional without meds. But it seems like SSRIs in general are the problem. (I also remember being on clomipramine as a teenager and it also gave me much more frequent headaches. This was before I started having severe migraines though so idk) Has anyone found medication that works for them and helps them manage OCD that ISNT an SSRI? Or, has anyone found alternative treatments if medication was not an option for you? I am doing ERP through NOCD already, but I’m wondering about lifestyle changes that have helped, cognitive practices, etc? Thank you for reading/responding 💗

jj5788

Date posted: Yesterday

Look up inhibitory learning for ocd, I think it’s something that can help your ERP

aralways

Date posted: Yesterday

@jj5788 Thank you :)

Ocd;;;;;;

User type: OCD Conqueror

Date posted: Yesterday

Definitely talk to your doctor if you stop, as they might recommend a slow taper or another med. Migraines: I would recommend going to see a neurologist or psychiatrist (or both). There are meds that may work to target both ocd and migraines. You can also go to physical therapy for TMJ pain to get exercises (or a specialist if you have further issues with tmj). If it’s extreme, you can get Botox for migraines and tmj (depending on how often you have headaches and migraines - look up your coverage so you know what your insurance does and doesn’t cover). Also, look into OMT by a DO where they do massage and some pressure point stuff. If your migraines started after a concussion, there’s often post concussion treatment including physical therapy.

Ocd;;;;;;

User type: OCD Conqueror

Date posted: Yesterday

Additionally, try and narrow down your triggers if possible. You can keep a food and migraine log, or track if it goes with menstrual cycles if you get those. Mine gets worse with dehydration and sunshine (water, wearing hats, and doing 15-20 minute ice on my neck to maintain status quo is helpful)

aralways

Date posted: Yesterday

@Ocd;;;;;; Thank you for such thorough advice!!! I’m only on 10mg Prozac which is the lowest dose available to me so there’s no need to taper it. I did msg my psych, I’m hoping we can find an alternative that doesn’t work on serotonin but I’m not sure. The migraines are genetic for me :( I just started keeping a log though and tracking triggers. So far the big ones are soy, SSRIs, and skipping meals/not eating enough. It sucks having to chose between unmanageable migraines or unmanageable OCD !!!

Ocd;;;;;;

User type: OCD Conqueror

Date posted: Yesterday

@aralways I believe ultimately you will be able to find a medication that works for both. Prozac is like the very first line medication and that’s a pretty low dose. It’s likely if you’re doing therapy that that’s working. I was told once it’s 20% medication and 80% you ❤️ so keep up the good work. There are a LOT more meds you can try, both for your migraines and for ocd. If your psychiatrist doesn’t have ideas, find a new one and see a neurologist. But also look into the other things I mentioned. I guess I don’t know what differentiates genetic migraines from concussion ones (ie I have family just of migraines but they didn’t start until after concussion so it’s probably a mix), but it could be that your family didn’t figure out their triggers either, or never tried seeing a neurologist, physical therapist or DO who does OMT. I would pick one (probs a neurologist) and ask for referrals while you’re there. You should at the very least have a short acting migraine med like ritzrapam (spelling is probs wrong) or sumatriptan.

Ocd;;;;;;

User type: OCD Conqueror

Date posted: Yesterday

And there are absolutely non ssri meds that are for migraines. Keep asking if what you have isn’t working. And if they aren’t helpful, find a different provider or try to find a head and neck clinic or specialist. You are truly at the very beginning if you’ve only tried 2 ssri’s. I’ve tried probably 15 different psych meds before (over time as different ones did or didn’t work, per my psychiatrists instructions) and 4 migraine meds (I have more comorbid conditions). Have you had a head mri? That’s another thing to cross off if the migraines get worse. Also helpful so they have a baseline so if things change later you have something to look back at. I hate to ask this cuz I hope you don’t have this, but have you ruled out MCAS?

Ocd;;;;;;

User type: OCD Conqueror

Date posted: Yesterday

@Ocd;;;;;; I feel like that sounded intense but what I’m trying to get across is there are SO MANY more things for you to try, there’s an incredible amount of hope and options out there for you and while I can’t say it’ll be a quick fix, or won’t take trial and error with meds for months or years, I do believe you can get short term migraine meds relief while being on an ssri.

aralways

Date posted: Yesterday

@Ocd;;;;;; YOURE FINE not too intense !! Thank you :’) As a teenager I went through like a million meds. Settled on anafranil and it rly changed my life. Came off of it a couple years ago. Stopped klonopin maybe half a year ago and was truly unmedicated for the first time ever and it was really rough and decided to restart meds. That’s when I decided to retry SSRIs and have tried 2 so far. I also did try Wellbutrin but that didn’t go well for me. I have sumatriptan but on SSRIs it stopped working. Off SSRIs I’d have bad migraines that last a couple days, sumatriptan would get rid of them. On Prozac I had migraines that would last 2 weeks at a time, always come back no matter what abortive meds I tried. Had to take steroids for the first time ever bc of it!!! Horrible Anyways. Long winded way of saying. I have tried tons of meds but also only like 2 or 3 as an adult. It’s all so hard to navigate.

aralways

Date posted: Yesterday

@Ocd;;;;;; MCAS no I haven’t ruled it out :( it’s possible. I have other symptoms that line up with it, the biggest one is random big hot red patches on my legs arms and chest that come and go. My understanding is MCAS is a little bit hard to diagnose and is generally more through process of elimination. I haven’t found allergy meds to be particularly useful for me which indicates MCAS may not be the issue. Idk :(

aralways

Date posted: Yesterday

@Ocd;;;;;; Thank you for talking about this with me!!! You’re awesome!! I’m stopping the Prozac today. I just can’t do the daily migraines anymore :( it’s impacting my quality of life. But I recently started a migraine journal and I’m hoping to pin down triggers better.

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