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Optimizing Medications

I am a 56 year old male - migraines since 40 or so, on average 20-25 days per month, no obvious triggers except altitude (skiing in Colorado) and exertion (running sometimes intensifies a budding migraine). Sumatriptan works for me but I get only 10 pills a month so I often cut them up as 1/2 or even 1/3 will suppress the migraine, otherwise I run out. I take Feverfew and Magnesium daily - Feverfew seems to help a tiny bit.
I have taken amitriptyline low dose (no help), topiramate (nothing), propanolol (nothing) and a litany of other meds with little success. Have experimented with ice and heat - very modest temporary relief of pain.
So here's the main point - I tried Aimovig - first dose no migraines for the entire month (haven't had that in past 10 years), but after that, waning effects to the point where I stopped it after 6 months and moved on to Nurtec as it is now approved as a preventative. After two months on Nurtec, no noticeable improvement - doesn't touch my active migraine and doesn't otherwise seem to reduce frequency or intensity.
Out of desperation during a really bad month and running out of Sumatriptan, I had one leftover dose of Aimovig (140 mg) and took it. So far, day 3, seems effective, at least for now.
Has anyone else had a similar reaction to Aimovig? Potent for first month, but then falls off.
I think Aimovig and Nurtec both work on CGRP receptors. I was considering trying Ajovy which, I believe, works on CGRP more directly. Since there's evidence for me that CGRP is involved with my migraines (Aimovig does seem to work, albeit temporarily) trying Ajovy seems like a logical next step.
Has anyone else jumped around like this, looking for the correct med? I suppose there are multiple types of migraines and finding the correct preventative med may be possible now with all of these options.
My doctor continues to push botox but I am trying to give the new meds a chance before going that route.

  1. Hi @Ulysses9, while you are waiting for a response from the community, I just wanted to let you know that many members try multiple CGRP inhibitors before they find the one that does the trick. -Warmly, Donna (team member)

    1. If you read through many of the stories on the site, you'll find that there are so many that have had similar journeys trying to find the right medications, and will find a medication that seems to be the one only to find the relief to be short-lived. It can be so frustrating, but we keep pushing forward. Please keep us updated on how you're doing. April - Migraine.com Team

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