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Medications & Prescription Treatment

Out of options?

  • By Anonymous

    I’m being treated by a wonderful headache specialist and I feel like I’ve just tried everything. I did Botox for about a year, but it no longer works. I’m now trying venlafaxine as a preventative. For when I get a migraine, I’ve run through all of the triptans – some don’t work at all, some work for a while, then stop working. I’ve tried midrin and indomethacin. My headache specialist is sending me to another headache specialist for a consultation at the end of September. I just feel lost – I still have a headache every day and about twice a week I have a bad migraine. About once a month I have a migraine that lasts about 5-7 days and I sometimes end up in the Emergency Room. I am very careful not to take medicine more than twice a week for fear of MOH. I’m wondering what other options are there? Any ideas? Anyone?

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  • By Nancy Harris Bonk Moderator

    Hi becky,

    I’m sorry you are having a rough time, but its good to hear your doctor is open enough to send you to someone else who may be able to help. If you’d like to check whether or not this new doctor is truly a migraine/headache expert, here is a link for you; http://www.ucns.org/globals/axon/assets/10300.pdf. All the doctors listed there are board certified in headache medicine.

    Seeing as you mentioned moh, you said you try and make sure you don’t take medication more than twice a week, does that include over-the-counter medications? These too can create real issues for those of us who are susceptible to moh. If you’ve not seen this information on moh you may want to take a look; https://migraine.com/blog/help-how-can-i-not-overuse-migraine-medications/.

    How about trigger identification and management? If we can identify our triggers and avoid the ones we can, and make necessary lifestyle changes we may be able to reduce our migraine frequency and severity. So, how do we do this? Keeping a detailed diary for about three months is the way to go and with all the apps out there it is easier than ever. Here is information stressing this; https://migraine.com/blog/importance-of-keeping-a-migraine-journal/. Migraine.com has the Migraine Meter you may want to investigate here; https://migraine.com/migraine-meter/.

    For information about what to include in your diary, we have helpful tips in this article by Kerrie; https://migraine.com/blog/keeping-migraine-diary-basics/.

    I hope this helps,
    Nancy

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  • By Anonymous

    Hi, Nancy – Yes, I try to not even take OTC medicine more than twice a week. I have so many triggers that I can’t count – I’ve done a gluten free diet, I’ve eliminated caffeine/chocolate/all the typical foods – alcohol is definitely a trigger. Weather is a trigger; too much/too little sleep; skipping meals… could go on & on! And sometimes I have no idea what brings on a migraine! I’m looking forward to seeing another headache specialist (Dr. Elizabeth Loder) and seeing if she has any more ideas. My current headache specialist is so willing to try more… I just think that she doesn’t know what to do at this point! I’m 43 and my current specialist has suggested a constant hormone therapy (Nuva Ring?), but I’m going to wait to talk to Dr. Loder before making a decision.

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  • By Anonymous

    I went to see Dr. Loder who IS FABULOUS. She is going to consult with my regular headache specialist. Some of her suggestions were to 1) re-try some of the past preventative treatments that worked for a while. She said we can “rotate” the preventative treatments. Sometimes a rotation of medications can work – the idea is to switch to a new medication just before the first one becomes ineffective. This will take time and experimentation 2) when I get a migraine, hit it with everything I’ve got – kind of like sending in the whole army instead of one soldier. I’m going to try the indomethecyn suppository along with a triptan and an anti-nausea. We’ll see! We’re hoping that by doing that, I can avoid the week long migraine that many times puts me into the ER. 3) She said a steady, low-dose hormonal treatment may help with any migraines that are hormonally related. We can try it for a few months and see if it makes a difference.
    She was wonderful to talk to and I am hopeful. Even though it will take time, I am hoping I’m on the right path.

    I’m wondering – does anyone else “rotate” preventatives or even “rotate” the medicine they take when they get a migraine?

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