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I am with Cliff as a fellow sufferer, Mind you I find the diclofenac can smart a little. Think vindaloo the next day! A good blast of diclofenac and the nausea normally settles without antiemetic but i keep a small stock of buccal prochlorperazine for emergencies. Does anyone get the munchies for carbohydrates the day after and a massive diuresis or am i just odd? Andy Volans Emergency Medicine Scarborough ( for as long as they keep it open!) > Diclofenac suppositories are fab, particularly for patients with gastroparesis. I suffer occasionally from migraine and a full blown attack will leave me photophobic and vomiting. PR diclofenac sorts me out. I usually prescribe 100mg PR diclofenac and a kip in a dark room for my patients with migraine. I don't like giving metoclopramide, prochloperazine, or chlorpromazine since I've experienced akathisia with all of them and I believe we underestimate the frequency of unpleasant side-effects from these drugs because patients don't know to report them. > >Dr Cliff Reid >Consultant in Emergency Medicine >North Hampshire Hospital NHS Trust > > > > >Disclaimer - July 28, 2006 >This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to which they are addressed. Any views or opinions expressed are those of the author and do not represent the views of the North Hampshire Hospitals NHS Trust unless otherwise explicitly stated. The information contained in this e-mail may be subject to public disclosure under the Freedom of Information Act 2000. Unless the Information is legally exempt from disclosure, the confidentiality of this e-mail and your reply cannot be guaranteed. > > >-----Original Message----- >From: Accident and Emergency Academic List >[mailto:[log in to unmask]]On Behalf Of Vic >Sent: 28 July 2006 19:56 >To: [log in to unmask] >Subject: Re: Migraine/Triptan therapy > > >I suffer from Migraine occasionally and make sure I carry a triptan around >in the car, in my bag, at home, and on holiday. I find I have 20 minutes >from the start of the right inferotemporal scintillating scotoma to the >onset of the headache and a triptan aborts it completely if taken at that >stage. Now I know lots of people react differently so this is just personal >experience but I know it has helped others. > >I really suffered as a kid, but basically I was bullied by big brother (some >of you know him - he's in medicine too). My migraines resolved largely when >I realised at the age of seven that I could win the fight if I kicked him in >the gonads (Stress relief, empowerment etc). I started with migraines again >as a GP, then read the label of this new Red Bull drink I'd taken a fancy >to. Then a few years ago I started having daily migraines. I was actually >having one when a young lad came in with his mother. He was getting >migraines too. Mum asked if I had a list of things he shouldn't eat and I >went on Google to find one. I found this >http://altmedicine.about.com/od/popularhealthdiets/a/migrainediet.htm >I had started having banana smoothies for breakfast. If I don't have more >than three bananas a week I'm fine. I've given the printout to hundreds of >patients now and they almost all report that the migraines get a lot less >frequent. As for the others - they just have to learn to kick the bugger in >the balls! > >Vic Calland > >-----Original Message----- >From: Accident and Emergency Academic List >[mailto:[log in to unmask]] On Behalf Of Adrian Fogarty >Sent: 28 July 2006 07:47 >To: [log in to unmask] >Subject: Migraine/Triptan therapy > >What is the accepted wisdom on the management of acute migraine these days? >Do most people stick with the tried-and-tested methods of analgesia, >anti-emetics and fluids? Or do many of you now use triptans, and if so, in >which particular patients or perhaps as a routine? Am finding it very >difficult to find any good evidence or consensus on this particular >question. Any advice gratefully received. > >AF > >________________________________________________________________________ > >Doctors.net.uk education: totally independent, totally free. >http://www.doctors.net.uk/education >_______________________________________________________________________ > > > ________________________________________________________________________ Doctors.net.uk education: totally independent, totally free. http://www.doctors.net.uk/education ________________________________________________________________________