methotrexate and migraines?

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Date Joined Jan 2004
Total Posts : 4151
   Posted 8/10/2009 11:34 AM (GMT -6)   
As you all know, I have been taking methotrexate and its been doing wonders for my joint pain.  Shortly after I started taking the methotrexate, I started getting headaches and they eventually upgraded to migraines with MAV (migraine associated vertigo) however I never associated it with the MTX.  I have dealt with it and have been taking my Fiorinal for the migraines. 
A few weeks ago, I called doc to request to not take the MTX one weekend because my son had a basketball tournament and I wanted to feel well enough to go.  That entire week after that weekend, I experienced no migraines or MAV so I called my doc on Friday to get an appt to discuss if maybe MTX was causing my problems.  The nurse agreed and made me an appt with the PA for the following Tuesday.  She said that it didn't sound like common MTX side effects (especially the vertigo) but that she would put me on Arava instead. 
I started the Arava on that Tuesday evening and by Thursday afternoon had a whopper of a vertigo attack and shortly afterwards a migraine.  That was this past Thursday so I decided for myself that I would stop the Arava and have made an appt with the Neuro which I'm going to see on the 24th.  I'm still kind of spacey but I'm taking my migraine meds to prevent any migraines at least for the next few days (I'm at work and I cannot get any type of attacks here).
Has anyone experienced migraines or MAV with methotrexate and/or Arava?  Maybe this just happens to be a coincidence?
Dx: IBS 1989, Diverticulosis 2004, Idiopathic Acute Colitis 2006, UCTD 2007, Localized Scleroderma 2009, Raynauds 2009
Meds: Plaquenil 400mg/day, Pred 2.5 mg/day (tapering), Methotrexate 10mg/week, Hydrocodone PRN, Flexeril PRN, Fiorinal PRN, Baby aspirin, Prenatal Multi, Vit E, B12, Fish Oil, Biotin, Calcium, Folic Acid

Veteran Member

Date Joined Dec 2005
Total Posts : 1950
   Posted 8/11/2009 9:00 PM (GMT -6)   
I had them with lamictal, but it is such a common side effect for lamictal that they actually call them "lamictal headaches" and I got double vision and vertigo. I also get just headaches with demerol. Both times I had to quit the medication as it was supposed to be asign of a serious side effect. Have you tested your blood pressure and blood sugar? Have you taken your temp? Sometimes I get very dehydrated and my blood gets thick and I have to drink gatorade or go to the ER and get fluids. B12 can cause some nasty headaches if you take too much, at least it does in me. Did you have the anticardiolipins and antiphospholipids (are they the same?) done? I think if the migraines and vertigo persist you should get some labs done through the ER or doctors to see what is going on.

Maybe it takes a while for the MTX to get out of your system too, or maybe your system is "rebounding". I got bad when my steroids wore off and lucky I got more, got bad migraines and vertigo and thick blood and dehydration when the taper ended too quick. My endo told me whenever our hormones get messed up we run a risk for electrolyte problems, we may get really thirsty and drink too much water, then we need electrolytes, so she told me to always keep gatorade on hand to stop excessive thirst.

((((Babs)))) so sorry you are going through this now. My ent ordered a hearing and balance test for my vertigo but I wasn't having problems at the time and it didn't show things. I know have to run in and get a new test when it starts acting up again.
Love, Marji
Ills--Sjogrens-Lupus cond., AI polygland. dysfunction 2, hyper/hypopigment, scoliosis,kyphosis,stenosis, deg.,O.A.,spine surgeries, salivary/lymphectomies, NASH, COPD, RLS, UT/GI bleeds, hystero, brain/nerve damage,TB
Meds--INH,Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, HRT and Lidocaine patchs, Voltaren gel, Klonopin, Vicodin, Restasis, Albuterol, steroids

Veteran Member

Date Joined Mar 2005
Total Posts : 589
   Posted 8/14/2009 8:15 PM (GMT -6)   
YES!  I have found that MTX gives me headaches, about 8-10 hours after I give myself my injection I find that I tend to get a headache, a few times they have moved into the migraine zone.  I find if I take Excedrin Migraine or Excedrin Tension Headache and drink LOTS of fluids and take a double dose of Folic Acid I can get the to subside pretty quickly. 
I also find that I have more headaches during the week, but they do go away within a few hours.   I see my Rheumy and GI this week and will be discussing the headaches with both of them.  The results that I have had with the MTX have been wonderful that I will take the headache than go off. 
Diagnosed with Lupus - April 2002
Diagnosed with Crohn's Disease (and all the lovely things that come with it) - January 2003 (problems since early 1990)
Fibromyalgia 2005 
Normal Meds:  Ambian 10mg, Flexeril 10mg as needed, Plaquenil 400mg, MTX 25mg Injection, Probiotics
"Extras" Right Now for Crohn's Flare:  Pred 5mg, Entocort 9mg

Veteran Member

Date Joined Jan 2004
Total Posts : 4151
   Posted 8/17/2009 8:11 AM (GMT -6)   
Hi Marji & Ellen,

It's good to know that you can get them before they get too horrible. I think it wouldn't be such a problem for me if it wasn't for the vertigo that I get with them. Since I have gotten off both the MTX and Arava, my headaches are subsiding albeit slowly but I feel the progress. I know these meds can take forever to get out of your system. Maybe if the Neuro can find a preventive med for me to take and still take the MTX, that would be wonderful. I'll give an update after my appt next week. Thanks for posting and confirming that it is possible for these migraines to inflict you while on MTX.

Dx: IBS 1989, Diverticulosis 2004, Idiopathic Acute Colitis 2006, UCTD 2007, Localized Scleroderma 2009, Raynauds 2009
Meds: Plaquenil 400mg/day, Pred 5 mg/day, Methotrexate 10mg/week, Arava 20/mg (what next???), Vicoprofen PRN, Flexeril PRN, Fiorinal PRN, Baby aspirin, Prenatal Multi, Vit E, B12, Fish Oil, Biotin, Calcium, Folic Acid

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