I want to decrease the amitriptyline, I went from 37.5mg to about 18mg over 2 weeks. Is the pain coming back due to withdrawal?

Hello,

When did you start taking citalopram?

Is your migraine with aura? What are the factors that exacerbate it?

I think citalorpam is used for other conditions, but if you want to wean off the amitryptiline, is there an alternative?

Does the doctor know about weaning?

Yes, amitriptyline can be weaned gradually to avoid withdrawal effects (the rebound effect, which is the pain in your case, can be one of these effects) but the ideal is to think about putting another migraine prevention medication with a good tolerability profile in place at the same time as weaning from amitriptyline.

Hello.

Yes the pain can be related to withdrawal (that's what we call the rebound effect), if you want to continue, take a painkiller like Tyelnol or generics, if it doesn't work try to wean off more slowly.

My question was also, if amitryptiline works well to prevent migraine but causes side effects (can you describe them to me please?), then the ideal is to change it by another drug, same or different mechanism

Excellent, like I said, the main thing is to wean off and start another one to prevent the migraine. So now if you want to maintain 18mg and take the other painkillers as needed and it works in terms of effectiveness, fine. If not, you have to slow down the weaning just long enough to see the doctor to have another alternative.

Yes of course, amitriptyline was effective, right? Are you taking any other medications for other reasons besides citalopram? Do you have any allergies?

There are several medications that are used to prevent migraines, of course taking into account the patient as a whole. What we see more in practice are propanolol, amitriptyline, topiramine.

I am also attaching a dietary approach to be favored in people with migraine.

**Migraine periodically causes intense and very painful headaches. We cannot predict exactly when a migraine will appear. However, for some, it seems that dietary factors can trigger it. If this applies to your migraines, you may be able to reduce their incidence by making changes to your diet: Eat small snacks often When you go for long periods of time without eating, especially after sustained exercise, your blood sugar levels may drop. Low blood sugar has sometimes been linked to the development of migraines. Try to avoid certain foods Some foods seem to have the power to trigger a migraine. However, they don't do this for everyone. You can try avoiding certain targeted foods for a while (one by one) to see if your migraine frequency decreases. If you don't see any difference, you can gradually resume eating them. These foods are : Foods to avoid Aged cheeses Brie, camembert, cheddar, mozzarella, gouda, gruyere and others. Caffeine Coffee, tea and colas. Chocolate and cocoa Dessert and drinks. Fruits Strawberries, oranges, mandarins, lemons, grapefruits and tomatoes. Beans Gourgans (swamp beans), chickpeas Alcoholic beverages Beer, wine (especially red), port, liquors. Meat extracts Bovril and Oxo. Yeast products Brewer's yeast, fresh bread, doughnuts. Added moulds Yogurt, sour cream, mushrooms, vinegar, soy sauce, sauerkraut, condiments and pickled foods. Food additives Monosodium glutamate (Chinese food and seasonings, chips, nuts and peanuts); aspartame (beverages and diet foods); nitrites (cold cuts, bologna, salami, ham, etc.). There is no guarantee that these measures will reduce the intensity or frequency of your migraines. However, many people benefit from them. **

With pleasure. Likewise.