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Allergic to Triptans, Botox not working as well as it used to... Help!

Hi there! I've had migraines since the onset of puberty, almost 30yrs. I've tried everything. I'm severely allergic to Triptans and I can't remember everything I've tried over the yrs to try to make them better. Mine last for days, leaving me bedridden and generally unconscious. Right now I get Botox, I use high CBD/low THC cannabis and as a last resort, narcotics. I have other chronic pain issues, including fibromyalgia for which I'm on narcotics. I'm looking at the probability of getting off the narcotics and I'm going to hafta learn how to deal with all my pain, but the scariest for me are the migraines. I've reached the point where Botox isn't working as well as it used to. My old dr raised the dose of Botox 2 months ago and I've had more migraines this cycle of Botox than I ever have before. Can you build up a tolerance to Botox like you do narcotics? Can it eventually become ineffective? I don't know what to do at this point and I'm wondering if anyone has any suggestions. I've found a new pain mngmt dr, my neurologist has given up trying to help since Botox has worked for the past few years and I'm at my wits end. I'm in day 3 of a terrible, sick migraine. I'm treatment resistant and when I go to the ER it's guaranteed that I'll spend hours there cuz the Drs want to try every migraine cocktail they know before resorting to mirphine, which knocks me out and breaks the migraine. Does anyone have any suggestions? Please help me! I don't know what to do! Thanks!

  1. Hi Ajs,

    Thank you for your comments. I'm sorry you are having a difficult time right now. Migraine is frustrating and exhausting - I hear you.

    Complicated cases such as yours (and mine!) are better served when we see a true migraine expert rather than a neurologist. Here's why - migraine/headache experts are board certified in headache medicine and treat one condition all day, every day - migraine and headache disorders. Neurologists may be fine doctors but have a hard time being experts in one area because they treat so many different conditions such as epilepsy, stroke, multiple sclerosis Parkinson's and others. Being board certified in neurology is not the same as being certified in headache medicine and not all neurologists are migraine/headache experts and not all migraine/headache doctors are neurologists. Does that make sense?

    I know it may feel as if you've tried every medication out there for migraine, but that really may not be the case. There are over 100 medication available to treat migraine and if you add up all the different combinations, that number goes up dramatically. Take a look at this article for more information on migraine prevention;

    I hope that helps!

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