Imigran and similar triptan migraine medications?

[ulrikakroon]

Hi!

I know there are LOTS of threads on migraines and some on medication but I'll start one anyway since I can't find one recent that fits my query!

I get mild migraines - which I do dive with (being a dive instructor doesn't really let you decide when to dive or not ;-). Sometimes they are worse and I'll take an Imigran (I think it's part of the triptan- or wahetever that family of medications is called, those that do funky things to your bloodvessels). It immediately releives the headache and apart from a slightly funny feeling in the neck and when I swallow, I feel great. My blood pressure is fine.

So, can I go diving now? I have heard about increased risk of DCS and narcosis. Does anybody know? I have gone diving on medication and so far so good but I don't want to make it a habit before I know.

Ulrika

 

[DocVikingo]

Hi Ulrika,

Imigran (sumatriptan succinate) is classed as a triptan. This type of compound causes blood vessels to narrow.

The drug can have a variety of side effects, including: pain, tingling, heat or flushing in parts of the body; sleepiness, dizziness & tiredness; nausea & vomiting; changes in blood pressure; feelings of faintness; visual disturbances; and, shaking & tremors.

As can be seen, a number of these, e.g., sleepiness, dizziness & tiredness, could pose a threat to safe scuba so the user will want adequate topside trials to assess for adverse reactions.

As regards the report of a "slightly funny feeling in the neck and when I swallow," feelings of warmth, heaviness, pressure, tightness or pain in certain parts of the body, including the throat, are reported by some users. Although sometimes strong, these usually only last a few minutes. If they continue or are particularly severe, they should be mentioned to the treating doctor.

In the absence of any worrisome side effects, there appears no reason to anticipate increased risk of DCI or narcosis.

However, this medication does not always relieve the migraine and in that situation there are the obvious concerns about diving during an attack.

Here is what Dr. Hugh Greer, DAN Southwest Regional Coordinator, had to say about diving with migraines in an "Alert Diver" article:

"A migraine headache is a periodic, usually one-sided, throbbing ache, sometimes preceded by warning signs and symptoms and of variable severity.

Migraine, though dreaded, is common. More than half the people in the world will have some experience with migraine during their lives, and about 5 percent will see doctors. A few of these will suffer significant disruption of their activities.

Fitness & Diving: Migraine poses little danger to divers. Even those with frequent migraine do not usually experience an increased incidence while diving. An elevated level of carbon dioxide in the blood, which occurs with decreased ventilation and breath-holding / hypoventilation, can theoretically precipitate a migraine headache because carbon dioxide (CO2) causes vasodilation in the brain. Increased levels of oxygen in the blood (which occurs in diving as well as in hyperbaric chambers) has been used with variable success to treat severe migraine, because it is a powerful brain vasoconstrictor.

Very complex migraine, with visual loss or paralysis, might lead to confusion in diagnosing a diving accident. However, little data exists to suggest that migraine poses a significant hazard to divers. Severe and incapacitating migraine headaches while in the water would create a hazard for the individual. People with severe and incapacitating migraine should probably not dive."

The following also may prove informative:

Migraine and Diving
http://scuba-doc.com/mgrns.htm

Helpful?

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

Regards,

DocVikingo

 

[Zia]

With respect, it depends on the symptoms you have with migraine as to whether you should dive or not. The quoted article seems more to deal with cluster headaches than true migraine. I'm not sure what the OP means by "mild" migraine -- each one varies in severity, but I've never heard of anyone consistently having mild migraine. In my case ( as is the case with many migraine sufferers) I have what is called an 'aura', and I can experience dizziness, severe nausea, hallucinations, numbness and have even (temporarily) been unable to speak comprehensively. Fortunately I have warning signs and take my meds to stave the full blown migraine off. And I stay well out of the water. I suggest the OP log her headaches and talk to both her physician and a diving doctor before going down with triptans in her system.

 

[ulrikakroon]

... to both of you for your answers.

Like I said, I have very mild migraines (just headache) so the actual headache does not really prevent me from diving, but of course it is more pleasurable without the head ache, and that's when the medication comes in handy. Nothing else works. And I don't get any other side effects.
I thought that because the medication narrow your blood vessels, that would make it dangerous, certain older threads here have pointed that way (DCS etc) but if that's not the case, then I'm sure I'll be fine taking it, especially if I stick to shallower dives. Unless pressure is likely to worsen or add side effects?
Ulrika

 

[Clyde Larson]

Is it true that cannabis can help you handling with migraine? I have been reading some articles regarding about this so i would know how can i handle with my sever migraine. All i know is that marijuana can give you a chill and relaxing vibe like this one from Purple Urkle .. Is there anyone here that can give me any idea about this? Any advice would be appreciated

 

[scjoe]

With respect, it depends on the symptoms you have with migraine as to whether you should dive or not. The quoted article seems more to deal with cluster headaches than true migraine. I'm not sure what the OP means by "mild" migraine -- each one varies in severity, but I've never heard of anyone consistently having mild migraine. In my case ( as is the case with many migraine sufferers) I have what is called an 'aura', and I can experience dizziness, severe nausea, hallucinations, numbness and have even (temporarily) been unable to speak comprehensively. Fortunately I have warning signs and take my meds to stave the full blown migraine off. And I stay well out of the water. I suggest the OP log her headaches and talk to both her physician and a diving doctor before going down with triptans in her system.

The article is describing migraines not cluster headaches. Cluster headaches are not of variable intensity, they are excruciating, and also referred to as "suicide headaches." They don't occur periodically. They occur in clusters that can last for weeks or months at a time (same time of day every day) and then disappear for a year or more. What may trigger a headache during a cluster period (e.g., alcohol), won't trigger one when the cycle is over.

 

[2airishuman]

Ah, youth. You are all fortunate to live in an era where migraine is better understood and treatment is widely available.

I think I was 26 when triptan drugs first became widely available, and were suggested for me. Up until that point, there wasn't anything that worked. At all. I did a lot of things with the condition that I now know was migraine, because the only alternative was to sit alone in a dark, quiet room for 8 hours and wait for it to go away. Hard to make a living like that.

The experience of migraine varies from one sufferer to the next. Yes, some people have mild migraines; for most people, some episodes are worse than others. Some people have aura without pain, most have pain without aura, some have the aura first then the pain, some get them at the same time, etc.

Side effects from triptans vary just as widely. Most people tolerate them well. Some have various sensory disturbances. Some have rebound effects.

I'm not aware of any evidence or studies regarding the effects of triptans on narcosis or DCS. Informed speculation, yes, but no goats.

Ultimately, you have to know your body and decide for yourself.

I am fortunate that, with the passage of years, the incidence has gone down to near zero.