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Comment by positr0n | Hacker News Reader

While people are offering anecdotes about their migraines:

1. If I don't eat sugar my migraine incidence goes from 8-12/month to ~1/month.

2. Excedrin works for me every time. The longer I wait to take it the longer it takes to work though. If I take it as soon as I feel a migraine coming on it will never progress to a painful stage. Before I discovered Excedrin I would have to go to sleep to end it, and occasionally throw up from the pain.

Note: My doctor said that Excedrin is a "perfect" drug for drug companies because caffeine is a trigger for many people, so they will take Excedrin and it will work, but then the caffeine will cause them to have another headache tomorrow and need it again. This doesn't happen to me though.

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Ditto about Excedrin––I'm like the Johnny Appleseed of Excedrin in Europe. Most migraine sufferers here seem unaware of the treatment options, and often are unaware even that their headaches are migraines. Just suffering alone in silence. Being American, I'll happily discuss my health problems with strangers. I disagree with your doctor about Excedrin rebound headaches--most sufferers (in my experience) don't have migraines very often, and would notice the rebound pattern. Many if not most are drinking coffee anyway. Me, I have an espresso a day, but supposedly espresso (generally arabica) contains less caffeine than drip coffee (often robusta). I attribute its positive effects to phytochemicals other than caffeine.

About sugar, I tend to agree. My mornings greatly improved after I cut out "part of a healthy breakfast" orange juice.

> but then the caffeine will cause them to have another headache tomorrow and need it again.

I think that this is rather about people for whom lack of caffeine is a headache trigger. I.e. a withdrawal symptom because they are used to caffeine.

Of course a caffeine-loaded painkiller will just delay the withdrawal.

If you want Excedrin without the caffeine you can just take a 500mg of acetaminophen and 500 mg of aspirin.

can i replace aspirin with something else?

Ibuprofen, like aspirin is a nsaid. So it should have similar effect when combined with acetomeniphin (Tylenol). In fact, acetomeniphin, ibuprofen is also commonly prescribed together. And some studies have shown it to be as or more effective than opiods like oxycodone for certain types of pain.

Well sure, but then you won't have an Excedrin equivalent.

To me paracetamol works. Or at least worked, until I got addicted, so we're trying to switch to apranax, which acts terribly slowly (plus we added divascan as a generic migraine reducer).

Now I'm at the point where doctors are telling me to avoid pain relief pills so four days out of seven are usually just shit. Makes life harder then it should be.

You got addicted to Tylenol? Could you be more specific? Do you just mean that it stopped working for you? Because if you mean you truly developed a compulsive desire to take APAP, you must be the first person in the world ever to have done so.

It is possible to be addicted to anything and it is quite easy with any painkillers, it doesn't have to opioid based one. Subconscious fear of pain is enough to take them in advance, just in case, every day.

No no, not in advance, but when I could claw my eyes out because of the pain - the problem was that slowly, year after year it worked less and less.

APAP metabolizes to AM404 in vivo, which acts indirectly on the cannabinoid receptor type 1. AM404 is likely responsible for a large amount of the pain relief (and, unsurprisingly, an anticonvulsant effect).

I suspect it's tolerance and not addiction, but docs see this and code it as "medication overuse headache" all the time.

Saridon but all the same I guess. Not my wording though, but the doctor's.

Replace the caffeine with Diphenylmethylsulfinylacetamide?(Modafinil)

Serious question: Can anyone pronounce a compound name that long in practice/conversation? Is there a specific naming rule?

It looks intimidating but there's a very much countable set of possible sub-units that makes up those words.

With enough organic chem experience, pronouncing and grokking structure from a name becomes second nature.

In my head it immediately becomes chopped up into understandable units: "di phenyl methyl sulfinyl acetamide"

There is more than one naming rule for organic compounds. The standardized one is IUPAC. That is to say:

https://en.wikipedia.org/wiki/IUPAC_nomenclature_of_organic_...

IUPAC is a standards body; that is their nomenclature.

From an IUPAC name, you can work out the molecular structure but IUPAC names are often longer than older names for the same compounds.

There are chemical naming conventions, though I certainly couldn't describe them in detail. But yeah, I can usually pronounce such things if occasion calls for it. One simply has to be familiar with all of the common morphemes for different common bits of chemical structures, and read them off like a sequence of separate words that incidentally happen to have had the spaces removed.

Germans?

No one would ever use that terminology in practice/conversation.

You’ve never met any pharmacists then?

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