My daughter has been getting migraines since she was 7. She gets the headache along with nausea and vomiting as the worst of her symptoms. She is under the care of her pediatrician and has also seen a neurologist. We started a daily preventive of Amitryptaline about 4 months ago. She is taking 25 mg a day and uses Imitrex nasal spray for episodes. The daily just isn't working. Does anyone know if changing the dose to 50mg will have an impact or is it time to try a different one? I'm not sure how long to give the medication time to start having a significant impact on the frequency of migraine. We are treating about 2 headaches a week with Imitrex and using Advil on other days as we are trying to avoid any rebound headaches. I feel helpless at this point. She needs relief. She misses school and sports too much. Going to pediatrician tomorrow and will ask about the increase in dosage of Amitryptaline but still wonder if anyone on this forum could offer advice and support. I feel desparate.