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Five essentials for relapse prevention

Thanks to Botox, I am enjoying a nice break from the symptoms of chronic migraine. I finally have a treatment regimen that keeps the attacks down to one or two per week. Most are quickly and easily treated, too. It really is a welcomed change.

I also know from experience that treatment success does not equal a cure. It is possible that I will continue to have good results for many years. It is equally possible that this brief hiatus will end much sooner.  It’s really hard to know how long a treatment plan is going to work. One of these days my team and I will have to go back to the drawing board to create a new plan.

So what do you do when a previously successful treatment starts to fail?


1. Talk to your doctor.

Work with your doctor to create a new plan. It might mean an increase in dose, the addition of a second medication, transition to a new medicine, or the use of some of the newer non-pill treatments. You may have to get creative by using non-conventional treatments in addition.

2. Track the changes meticulously.

If you’ve been doing well for awhile, you might have gotten out of the habit of keeping a migraine journal. If you notice an increase then it’s time to start tracking again. Perhaps you’ve been exposed to a new trigger? Maybe your sleep patterns have changed.  Even healthy changes can trigger a change in migraine activity. Losing weight or eliminating the need for another medication can affect migraine.

3. Maintain good headache hygiene.

Continue to avoid known triggers where possible. Try to maintain a regular schedule of eating and sleeping. Stay hydrated. Avoid overheating. Wear tinted glasses or sunglasses to protect from light triggers.

4. Continue treatment as directed.

Stopping treatment suddenly could spell disaster. Even if you think it’s not working, keep using it until your doctor suggests alternatives. You’d be surprised how a sudden discontinuation of medicine can mean a huge spike in attacks. If you think it’s bad now, it could be a lot worse if you stop taking medicine “cold turkey”. Talk to your doctor about safely weaning off before you discontinue a medicine.

5. Try to stay positive.

If you’ve had treatment success before, then you can do it again. Remind yourself that finding the right treatment takes time and lots of trial and error. If you get too discouraged, reach out for help from an online or local support group or even a therapist who specializes in chronic pain.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Thomas
    4 years ago

    SJD: the difference in the effectiveness of your Botox treatments probably had to do with the injection points. Your first round probably hit the exact correct points.

    The Amrix is extremely new on the market. If is non-formulary in most health plans. The manufacturer might be able to help with cost.

    Good luck!

  • SJD
    4 years ago

    I tried botox and it was amazing how well it worked after about 10 days. Then that doctor left the practice. I later had botox from other doctors and nurses, but it never helped me again. I don’t know what the difference was. I finally just couldn’t afford how expensive it was and was getting nothing out of it any more so I stopped.
    I will look into Amrix as I have not heard of it.

  • Thomas
    4 years ago

    I too have just gotten Botox for the first time. The improvement was immediate, which I attribute to mind over matter ( the effect was to kick in in 7-10 days). after the first few days I was back to my normal daily migraine.Checking back with my migraine Doc, she prescribed Amrix, and extended release form of Flexeril. OMG! The relief was instant and has last about a month now. I have gone from daily chronic migraine to maybe one mild one per week if that. And I can defeat very easily with just a triptan and no pain med.

    Tom Lisowski

  • Tammy Rome author
    4 years ago

    So happy to hear that you are having success! May it continue for many years.

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