I am a lifetime migraneur, as the affliction is called, and I was prescribed loads of fioricet (same thing but with acetaminophen instead of aspirin in the cocktail). I no longer take fiornal, fioricet - or anything else in that family. Why? In the words of one of the top headache docs in NYC: "it works too well."
Fiorinal is a combination of caffeine, aspirin and phenobarbital. Yes, phenobarbital, the very same potent barbiturate that killed, among others, Elvis and Marylon Monroe. Doctors up on their literature rarely prescribe fiorinal type drugs for many reasons, the big ones I'll list here: 1.) Phenobarbital is a highly potent respiratory depressant any sort of metabolic disorder causing a slow metabolism of the substance, over-dosage by a small margin or mixing the drug with other respiratory depressants (benzos, opiode painkillers and ESPECIALLY alcohol) can lead to respiratory arrest, and death. There is a reason they invented Valium (a potent benzodiazepam that works along the same neural pathways): Phenobarbital simply killed too many patients. 2.) Fioricet - in a vast majority of cases - causes intense "rebound headaches;" I.e., once you've metabolized the drug and it has cleared your system, your headache returns, and with a vengeance. That leads to 3.) Phenobarbital, and medicine containing it (fioricet and fiorinal) are HIGHLY habit forming, more so than most opiates. Furthermore, because the drug works on the same pathways as alcohol and benzos, withdrawal can - and this is true, epidimiologically speaking - for these three substances - be fatal.
Phenobarbital, like alcohol and benzos, raise the seizure threshold - in fact, it is a first-line intervention in ER medicine for patients in grand-mal seizures, although faster-acting benzos such as Ativan are generally preferred, as the therapeutic spectrum is much wider. Prolonged use leads to tolerance, and when discontinued abruptly, fiorinal can cause life-threatening seizures - think delirium tremens on crack. I know this personally, as it happened to TWO very close family members, both of whom were hospitalized for a week to detox off the medication.
Any prescriber who describes fiorinal as "side-effect-free" is, IMO, guilty of medical malpractice and reckless endangerment. There is, currently in the medical community, a strong push to have the FDA remove these medications from the market (try getting your gp to give you a scrip for phenobarbital for anxiety or sleep; you could easily, if you had a time machine. They rapidly fell out of fashion in the mid- to late-sixties due to their narrow therapeutic index, their low safety index and their extreme potential for abuse.
An easy google search - or, for the more scientifically inclined - medline/pubmed search - will yield months of reading and research to back up what I've written above.
Fiorinal, far from being side-effect-free, has the potential to be an extremely dangerous substance, even when taken as prescribed. From the medical literature and annecdotal - and personal - experience, fiorinal is rarely taken as prescribed. The rebound headaches lead to maintenance dossage, which leads to tolerance and increases in dosage, which leads to severe addiction and potentially catastrophic effects on one's health and lifestyle. Plus, take one or two too many after a drink (what's the major cause of headaches anyway?) and that may be your last headache. Ever.
I'm not trying to be a teetotaler here, but it is a public disservice to describe fiorinal, fioricet and any other medications in the barbiturate family as "side-effect-free." On the contrary, they are highly potent medications that carry very real risks, and one must carefully weigh those risks against the severity of the condition being treated. With so many newer, safer and more effective medications on the market to treat migraines (for which fiorinal and fioricet are contraindicated - they are exclusively effective for tension headaches which are far milder than the former and rarely require prescription pharmeceutical intervention), one must be very careful should he choose barbiturate-based medications for headache management. Diet, excersize and other basic lifestyle changes are alone far more effective, and far safer.
Of course, everybody reacts differently to medication, but my advice would be to find your hubby's doctor and knock him in the head with a mallet and see how he treats that headache.
Best of luck and my thoughts and prayers for you and your husband's health.
Thank you for bearing with me!
PS. No side effects at all.
