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Need help with medications

I’ve been struggling with migraines for 12 years. The past year they have been terrible. Pretty much 6 out of 7 days I have some sort of headache or migraine. Botox doesn’t seem to work (I’ve done 2 treatments). Just recently sumatriptan has stopped working. I’m really struggling and I need medication ideas to discuss with my doctor. Every time I go I just don’t feel listened to and they don’t discuss anything new. Please help!!!

  1. HI ashely8888,

    I'm sorry things are so difficult right now. I can tell you it can take three rounds of Botox for some of us, myself included, before we see a reduction in our migraine attack frequency and severity. Hang in there!!

    Also, Botox used for migraine prevention, it's not a cure. We still need to be vigilant about our migraine triggers. Staying hydrated, not skipping meals, keeping a regular sleep schedule are all important parts of a migraine management plan.

    Is there any chance you are using sumatriptan and/or pain relievers, whether they are over-the-counter or prescription, more than two to three days a week? If we do so, we may create another issue called rebound headache. If we are in a rebound cycle, our migraine attacks may be more difficult to treat and we can end up in a daily cycle of pain that too, may be hard to break.

    Don't lose hope!! There are over 100 medications and supplements that can be used to treat migraine disease. Let me share that information with you;
    https://migraine.com/blog/migraine-preventives-start.

    Feel free to share this with your doctor and keep me posted!!
    Nancy

    1. Hi Ashley! I'm really sorry you're going through this bad patch at the moment. A couple of questions and thoughts...

      -Has your doctor had you try any preventatives? Nerve blocks?

      -Like Nancy said, it can take several rounds of Botox before it starts kicking in. Even on Botox, it doesn't stop my migraines, but it does reduce things from constant-murder-thunderstorms to some rainshowers, some partly cloudy days, and some sunny days, if that makes sense? I think I've seen studies where it can take up until round five to see what your max impact will be from Botox. I would definitely not count it out, unless your doctor thinks you should or you're having some really gnarly side effects.

      -Sumatriptan. So, did ALL the triptans stop working for you, or just that one? If it's just that one, see what your doctor thinks about you trying another one. There are 7-8 different drugs in that class. Some work better for certain people than others. If ALL triptans stopped working, and you are having migraine attacks 6-7 days per week, you might talk to your doctor about the possibility of IV infusions. Those are something that can be prescribed by a neurologist or headache specialist. You can receive lots of different medication in an IV infusion (I think Nancy has a link somewhere, but off the top of my head... steroids, zofran, reglan, benadryl, depacon, magnesium, DHE, fluids), and they can be used to break up really stubborn headache cycles.

      -Is your doctor a neurologist? Are they a headache specialist? If you're having 6-7 days of headache per week, you really need to be under the care of a headache specialist. They will hopefully have more ideas.

      -And not to be overwhelming, but do you have an idea of what your triggers are, and are you able to limit your exposure to them? I know some of us, even if we try our darndest, our brains just want to have lots of attacks regardless, but have you been able to figure out of there is something you are eating, something in your environment, weather, stress, sleep pattern, hormones, smells, lights, sounds, that could be causing you to be triggered over and over?

      -Finally, there are some really hopeful drugs coming just around the bend, called CGRP. We aren't sure how long it will take for insurance to start approving them (crosses fingers), but people who got to be in the trials had some really good results. So don't lose hope. There ARE options out there.

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