Medication Reset: Starting Over to See What’s Working

By Holly Harding

1 min read

Have you considered going off of your medications? This is a question that can arise for those of us who live with migraine.

Unfortunately, there is no cure for migraine. In response, and in an earnest search for relief, we may add medication upon medication to our treatment strategy as we battle migraine over the years. This may result in a lack of clarity regarding what is actually working for us. Side effects of medications can sometimes rival the complex symptoms of migraine leading to the feeling that we are swimming in a migraine medication soup. Additionally, this condition can evolve over time, as can we, due to aging and hormonal changes.

How do you take a migraine treatment break?

A temporary break from our medications can help us gain clarity on what’s working and give us an updated picture of the severity and frequency of our condition. The actual logistics of taking a medication break are complicated (and can include detox) so need to be carefully considered and monitored by a doctor.

In this video, Holly discusses the various reasons people with chronic migraine might consider a temporary break from medications.

Going off of medications can be a significant undertaking and take major dedication and commitment. If this is something that you’re considering, it’s important to be under a doctor’s supervision.

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Cody Leach Community Admin
Thanks for bringing up this topic, <inline-mention username="Holly Harding" user-id="3755969"/>. It's such a difficult decision to make when we feel unsure if our medications are working for us. I know from my own personal experience, that taking a break from my medications after taking them for several years did help me get a better picture of where I was at with my condition. Even more so, I was able to learn that I actually did not need one medication that I was taking for migraine, and was able to leave that one behind. I don't think I would have been able to learn this without help from my doctor and giving my medications a short, but necessary pause. Wishing you well, and hope to see some more experiences about this topic in the comments soon 😀. - Cody (Team Member) 
1. Kimberly.broughal Community Admin
 <inline-mention username="Cody Leach" user-id="4536970"/> It's awesome that you were able to come off of one medication completely. I definitely think that this is worth exploring. I have thought about this but haven't yet brought it up with my headache specialist. I've tapered off medications before for other health issues and know it can sometimes be unpleasant. I do think though it might be really helpful and be a necessary step to take. Thank you for sharing your experience!! - Kim (Team Member)
Amanda Workman Moderator & Contributor
<inline-mention username="Holly Harding" user-id="3755969"/> This is such a difficult but overall important task. I have tried this once and it was definitely a rough experience. My family was concerned about all of the medications I was taking for my migraines and fibro. They wanted me to do a detox of my medications. Needless to say, I need to be on preventatives to have any sort of ability to function. - Amanda W (team member)
1. Kimberly.broughal Community Admin
 <inline-mention username="Amanda Workman" user-id="3715820"/> I agree with you in that it is a difficult task. Some of my family thinks I am taking too many medications and get worried about the combined effect on my body. I have been on many different combinations of medications for migraine and it's hard to really know which ones are actually working and which ones aren't really doing much. I would love to find this out but I fear I'd also have a rough experience, but this is certainly something I've thought about! -Kim (Team Member)
CommunityMember807d14 Member
I’ve tried this numerous times throughout my 38 year history of daily migraines, it did not make a difference for me, but I do think it’s worthwhile to give it a try. If nothing else it lets you know that you are NOT suffering from rebound headaches and (if your fortunate enough) it may be your answer. It can be dangerous to just stop some medications and you may go through withdrawal from others, so this is not an easy fix; you will want to have your doctor’s support as well as your family’s 
1. Holly Harding Moderator & Contributor
 <inline-mention username="CommunityMember807d14" user-id="8562900"/> Such good points you raise here about the importance of securing support from our doctors and family/support networks before engaging in this process. I also am so glad you mentioned the goal of sussing out whether or not rebound is at play. That's such a key question as it can be easy to fall into. Thank you for sharing your well-earned wisdom from a long journey with migraine with us. Glad you're with us. Warmly- Holly <a href='http://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team. 
2. Cody Leach Community Admin
 <inline-mention username="CommunityMember807d14" user-id="8562900"/> All great insights. Thanks for mentioning this and being part of the community 😀. - Cody (Team Member)
glassmind Member
I have sone this with mesications and with supplements. . I found that magnesium and bvitamins were making no difference, but that a combination of minerals in an electrolyte mix (without sugar) is essential for prevention for me. . I had to taper, eliminate, then restart clonozapem for Rem Sleep Behavior Disorder as the body had become tolerate to the dosage. I didn’t want to increase dosage, so chose this option. The experience was very difficult, my health suffered during the time. But I had very supportive family and essentially “dropped out” of life during the time. The medication is essential for me in treating RBD. And treating RBD is essential in preventing migraine flares for me. . I also tried a break from aimovig and found that it too is an essential preventative even with side effects. (I actually just posted in the crpg forum about this)
1. glassmind Member
 So many typos. Thanks for your patience everyone 
2. Holly Harding Moderator & Contributor
 <inline-mention username="glassmind" user-id="3906820"/> Thank you for sharing about this. It's a great and important point about taking a break from medications in order to improve their efficacy and reset the levels so we don't continue to escalate dosage amounts. And thank you for helping us understand the challenge related to coming off that med (before resuming it). I think many of us want to come off medications but are worried about how to do so given our lives and relationships. I'm glad your family was supportive. I think communication is key here -to let others know we are going to have to disappear for a bit may let our stress level down as we move through the process. Also grateful you posted here as well about experimenting with aimovig and then deciding it was essential to you. All this shows that you are not passively taking medications but rather really working to evaluate what's working for you. Good for you. Thanks again for sharing! Warmly- Holly <a href='http://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team
happywanderer Member
From experience, I can say this can be absolutely brutal. I had a Internal Dr who wanted me off all of my medicines. She had me stop taking 3 or 4? of them at one time (I was on more than that) She did not taper off...but had me stop cold turkey. It was absolutely horrible painful--- and I was so incredibly sick. Also, it is important to note that you may (will) need several days/week(s) off from work to deal with the aftermath/consequences/side effects. As I only get 5 sick days per year...this is not doable. 
1. MMS1956 Member
 That’s just ridiculous that the “dr” would make you go cold turkey. I put Dr in italics because no real Doctor would do that. I’d find another, if it was me. 
2. Holly Harding Moderator & Contributor
 <inline-mention username="MMS1956" user-id="3836265"/> - I agree. That is a cruel approach that lacks compassion and understanding of all that's involved in titrating off pain medications. Thank you for speaking to this. Warmly - Holly - <a href='http://migraine.com' target='_blank'>migraine.com</a> team
CommunityMember661558 Member
I am on a maintenance medication and an as-needed medication, the maintenance medication I take for a month and then off for a month, depending on the severity of my migraines. Lately it has been working as I have been off my maintenance medication since the beginning of 2024, and may have had 1 or 2 small migraines. It also was the recommendation from the neurologist that prescribed them almost 30 years ago, after having a migraine for 2 years straight!
1. Kiera_Rose Member
 Thank you for this advice, Holly. I think it’s valuable for people who don’t have migraines as well. We tend to pile on medications to treat a specific symptom then another med to treat a side effect, etc. (Especially with the elderly). I have done a full detox and it was hard. I did end up adding some meds back but I was able to cut a few that weren’t really helping. For me the now reset, which I do every 2-4 weeks, includes going off all pain meds, nausea, muscle relaxers, etc for 2-3 days. It’s miserable but it makes the pain meds more effective afterwards for me. Just food for thought. 😀
2. Holly Harding Moderator & Contributor
 <inline-mention username="Kiera_Rose" user-id="8515235"/> -thanks so much for sharing your insights with us. I hadn’t thought about it before but I agree that this topic is applicable to many populations. I’m impressed that you go through a mini detox every few weeks to reset the efficacy of your medication and to try to avoid tolerance issues. I don’t go fully off of my medications on a regular basis, but I do titrate down lower than the prescribed amount as doing so helps meet those same goals of resetting efficacy. Thank you so much for sharing this strategy with us and how it is working for you. Hope you’ll stay in touch. It’s wonderful to learn from you. Warmly - Holly - <a href='http://migraine.com' target='_blank'>migraine.com</a> team
Nancy Harris Bonk Moderator
<inline-mention username="CommunityMember661558" user-id="8606867"/> Thank you for joining the conversation. Good to hear your current medications are working - that's got to be a relief!! How are you today? Wishing you a low pain day, Nancy Harris Bonk, Patient Leader/Moderator <a href='http://Migraine.com' target='_blank'>Migraine.com</a> Team
ltclaw1 Member
 I take Divalproex daily as a preventative and Elitriptan as needed. I did not think the divalproex was doing anything until my prescription ran out and I went 2 weeks without it. 
1. Holly Harding Moderator & Contributor
 <inline-mention username="ltclaw1" user-id="4689556"/> -interesting. Sounds like you got to reevaluate the efficacy of one of your key medications sort of by accident. It can be really helpful to gain that understanding and appreciation for your medication regimen. Thanks so much for sharing this with us! Warmly - Holly - <a href='http://migraine.com' target='_blank'>migraine.com</a> team
Rs63123 Member
I still have chronic migraines and I am taking only 2 medications. Maxalt for acute and a beta blocker eye drops for rescue. I have been unable to find a reliable preventative. My triggers are allergy based and airborne and unavoidable. My doctor and I suspect that the Maxalt is causing rebound migraines and working on replacing the tryptan with a different chemistry, specifically Reyvow. Initially this seems to be working and has helped to break the rebound cycle. Note that this was only possible because I progressively scaled back all medications I once used for migraines which included opiates for rescue. I wish to add that for anyone concerned about Reyvow and it's effects. It does as well as Maxalt and by design is not able to create rebound headache conditions and chemically it targets only the key receptors for migraine. Respect the side effects of drowsiness initially as this medication is potent. I hope that this info is of help to someone.
1. cheribear Member
 Thank you. this was very helpful to me. I will research and talk to my dr about reyvow. I am also a chronic migraineur. maxalt/rizatriptan is my main abortive. I try to use it no more than once or twice a week to reduce rebound headaches. Aimovig and the other chirp’s caused me severe constipation so is had to try something else. Once i started on Qulipta combined with the every 3 months botox shots it made a huge difference. and I was able to be weaned off topimirate which helped me be able to find my words better again and be more present. My botox wears off after 6-8 weeks so that last month regularly i used to be pretty bed ridden but im a week away from my botox shots now and up and functioning many more days due to the Qulipta. It enables me to better be there for my family and make small difference in other people’s lives. Weather changes are my worst triggers Though i still really need the medications i am on to function at all, im very happy to have worked with my dr to get off the topimirate. 
2. Nancy Harris Bonk Moderator
 <inline-mention username="cheribear" user-id="3700654"/> I'm happy to hear this information resonates with you. I hear how frustrating it is to live with migraine disease - you're not alone. Many of us, myself included, didn't do well with topiramate. I experience lots of numbness and tingling that didn't go away and brain fog - no one needs that! On the other hand just as many do very well with it Some people get nerve blocks when Botox wears off. You may want to discuss this with the doctor at your next visit so you can have a better quality of life while waiting for your next round of Botox. Another thought - is your doctor very skilled in administering Botox? It make a huge difference. You can read more about nerve blocks here; <a href='https://migraine.com/living-migraine/nerve-block-injections-back-pain' target='_blank'>https://migraine.com/living-migraine/nerve-block-injections-back-pain</a>. I'd love to hear what you think and I'm sending you pain free wishes, Nancy Harris Bonk, Patient Leader/Moderator <a href='http://Migraine.com' target='_blank'>Migraine.com</a> Team
marinao Member
From reading all these posts, I am really amazed that so many people are on various multiple medications. I learned a long time ago that multiple medications can sometimes cause problems and also cancel one another out so I have always kept my medication for my migraines down to two--one to abort the migraine and one for pain. I reasoned that if I could maintain that cocktail for years, I could also eliminate any rebound headaches from too much medicine and also prevent myself from building up a resistance to the medication so it would no longer have the ability to help me. I needed to take responsibility for my headache control and did not want to be a prisoner to my medicines and strove for a balance of making lifestyle changes as well as using the medicines, only when I absolutely had to use them. After 19 years of taking Imetrix shots which worked beautifully for me with no side effects, I stopped them cold turkey in 2016. I stopped them because the veins in my legs were being ruined by the years of constricting my blood vessels as will happen with cigarette smokers. My ankles were swelling with just the slight intake of salt. It was painful and I was concerned at the level of fluids being retained in my body and I was not going to go on any diuretics. I truly dislike putting medicine into my body and I believe eventually the body pays a price for all of it and I have tried to limit the amount of medications I take. No one can take migraine medicines forever due to the lack of efficacy after a while and/or the nasty side effects. I made it a point to put up with some things, but would never put up with some of the side effects from the newer drugs that I read that many people do endure. I don’t want to feel sicker in other ways or tired. So what happened after I stopped depending upon those Imetrix shots? Well for years I had been already changing my diet and reading about any food that creates a new migraine for me and documenting it. Then I began eliminating the foods one by one. It took determination and willpower. I could not control the environmental triggers or the weather triggers, but I could control the food triggers. I decided then that August of 2016, I would have to deal with not depending upon those shots. I knew that this would mean that I would have to deal with not getting rid of the headache quickly and have to deal with experiencing the throbbing longer, but I found that through my changed diet, the migraine intensity and the downtime could be lessened. I went from five days, to maybe three or two days for a migraine attack. I never gave up my painkillers because I had to rely on them without the Imetrix shots, but I was willing to do this because I had made the choice to stop the shots. But I did not abuse the painkillers. A balance had to be reached and it was my choice so that my body would not be jeopardized anymore. I do not regret my decision but It took a significant undertaking and it was a major dedication and commitment on my part. I feel that not having a dependence upon the shots would force me to carefully do whatever I could to avoid any migraines in the future that would be triggered by food. I became hyper-vigilant about eating and my environment. I avoided loud sounds and bad lighting by never going anywhere without my sunglasses because even at night, lights can be horribly bright and trigger a migraine. I still get migraines, but I have made a significant dent in the frequency of them. I adhere to an incredibly restricted diet which may be hard for people that really enjoy food, but it was all a matter of what was important to me and I became so tired of the pain and lost time. In the world of migraine treatments, no one can be on the drugs very long. They just do not work forever. Maybe some people will be lucky and age out of their migraines as many have as they get older. My shots did not have immediate side effects, but it was the long term use that damaged my veins and created a circulatory problem. All I know is that I made the right choice by eliminating the shots. I only wish I had done it years ago. 
1. Holly Harding Moderator & Contributor
 <inline-mention username="marinao" user-id="3838036"/> Sounds like you've done a careful job to figure out your particular food triggers. Did you use an elimination diet to do so, or a food journal? I've often said that figuring out each person's triggers requires us to act as detectives in our lives. A magnifying glass aimed in every direction- watching for sensitivities to light, food, sound, and smells - and then those triggers that we cannot avoid such as hormone and weather changes. Getting to the bottom of our particular "case" takes real effort and then once we know our triggers, it can mean real discipline to avoid them, especially if we have multiple ones. Thanks for sharing more of your journey with us. Warmly - Holly - <a href='http://migraine.com' target='_blank'>migraine.com</a> team 
2. Holly Harding Moderator & Contributor
 <inline-mention username="marinao" user-id="3838036"/> That is so interesting about your different experiences while in Germany and Austria. And I like how you share the way you are still determining your triggers. It really can be a never-ending journey as our triggers sometimes evolve along with us! Thanks again for sharing! Warmly - Holly - <a href='http://migraine.com' target='_blank'>migraine.com</a> team
margowhite Member
I’ve taken a medication break every 18-24 months for over 35 years. I’m also a chronic pain patient so I know the importance of resetting my pain medication tolerance. The extremely unfortunate downside is that every time I do this, many of my doctors assume that I don’t need all of my meds, especially my pain meds, and the end result is I get less and less relief as I’m allotted a lower dosage on less strong medications. There was a time where I was on oxycontin, klonopin, and diazepam to treat everything I have going on, and I was pretty well managed medication-wise except my dosage was creeping on up there. After my medication break of 3 months I was told I’d never be allowed to have oxycontin again unless I was essentially dying and klonopin and diazepam were now off the table too because some bureaucrat decided medications I’d been on for years were suddenly going to kill me. Now I’m lucky if I sleep more than 3 hours a night, and never more than 1-2 hours continuously, and my pain, anxiety, and depression have been out of control since 2013. That’s over 10 years! The result is I had to go on extended medical leave and long term disability, social security disability, and things are almost as bad as they can get. The only meds that even help my chronic daily migraines are CGRPs that Medicare doesn’t cover. I’m screwed and I can’t do anything about it. What’s the point of barely existing?
1. MMS1956 Member
 That’s just ridiculous. I think it’s a real problem when politicians and bureaucrats get involved in medicine. I see that much much more in the USA than in my home country of Canada. I use marijuana in Canada but in most states it’s still illegal and frowned upon. OMG these politicians are so in the pocket of the pharmaceutical industry that I doubt it will ever be legal for medical or recreational in the entire country. Also once when we were in Florida I ran low on my Tramadol and I saw a Doctor in Tampa and he would only prescribe me 2 weeks worth. At home I get 6 months worth. The laws in the US are pathetic when it comes to this. I think you need to move to a state that allows marijuana use and just stay high, and or move to Canada. 
2. Holly Harding Moderator & Contributor
 <inline-mention username="margowhite" user-id="3819487"/> - Oh my- thank you for sharing some of your journey with us. First, good for you for trying regular resets with your medication regimen- these can be difficult for sure. I'm so sorry to hear what kind of intersections you've had to cross in your life with migraine. It is awful when we have effective meds taken from us. I also find it ludicrous that, for those of us on Medicare, the most effective treatments (CGRP, for example) are out of reach financially. I'm perplexed also that the savings programs that these drug companies offer are not allowed for those on Medicare. A true rock and a hard place. I wanted to check in with you about whether or not you are working with a migraine specialist? These doctors are more specifically trained in the neurological disease that is migraine. Happy to help with sending some referrals if you are in need. Just let us know. Also wanted to check in on how you are emotionally. Living in frequent severe pain plus other neurological symptoms atop depression and anxiety is a lot to ask of anyone. Have you ever thought to connect with a therapist? We recommend those of us living with chronic migraine to consider that kind of support due to how demanding and depleting migraine can be. In the meantime, we are here for you to listen, provide support and information anytime. We are so glad you're with us and hope you'll keep in touch. Warmly - Holly - <a href='http://migraine.com' target='_blank'>migraine.com</a> team
MMS1956 Member
Hi, I’ve had to go off my migraine medication twice because of starting new drugs to see if they worked better. It was hell, twice. I take Tramadol and have been for 12 years. I’m physically dependent on it and to come off an opiate is no easy thing. I have recently thought of going off again but every time I even think about it it fills me with anxiety. When we’re home in Canada I also use marijuana daily to help with ptsd and sleep. When we travel away for the winter that’s not possible so I usually have to increase my tramadol. Not much else I can do. 
1. Holly Harding Moderator & Contributor
 <inline-mention username="MMS1956" user-id="3836265"/> - Thank you so much for chiming in on this. Such an interesting perspective you bring from Canada. I agree with your point about the awful way governments can get in the way of effective medications. I keep hoping that marijuana will become nationally cleared for medical use. A lot of migraine patients have found help in that approach. And yes, willingly going into withdrawal is a tall order. It makes so much sense that it makes you anxious just to think of it. You are human and no one wants to invite that kind of pain and discomfort into your life. Have you ever talked to your doctor about decreasing the dosage- maybe by half for a while to see if that helps to reset efficacy? You do a great job of explaining the rock and a hard place so many of us find ourselves living in - reliant on pain medication due to a disease that is so difficult to control. We are with you as you work your way forward. Here to provide support and to listen anytime. Please stay in touch. Warmly - Holly - <a href='http://migraine.com' target='_blank'>migraine.com</a> team
jimmyblue Member
Re Medication Reset : It seems a periodic reset is needed. I find my Flunarizine loses its effectiveness over time as a headache preventer. I stop taking it for at least a month, or maybe 2., then start up again. It helps to wean off the drug for a few days at half dose, then stop taking it. While being off the Flunarizine I have tried Qulipta as a temporary replacement but it doesn't work very well ( I tried Qulipta for a 4 month trial. It worked for the first 2 weeks only, then not at all ). I also have had to stop taking Flunarizine a couple of times due to depression which is a well known side effect of the drug. Same weaning off routine. I have also tried living with just the half dose of Flunarizine for several months- no depression but not very good headache prevention either. After several trials it seems that taking the full dose of Flunarizine and taking a break from it occasionally is the best solution........Good health to all of us.
Alene L. Brennan, RYT Moderator & Contributor
<inline-mention username="jimmyblue" user-id="8588359"/> that can be all too common and all to frustration with managing migraine. Medication works for a period of time... and then stops working. It's disheartening to say the least. That's great to hear though that you were able to find a rhythm that helps it work again. The most important thing with making any changes to your medication, is staying connected to your doctor. They can help to best guide that transition off and one the medication in a way that it works with our body as best as possible. Thanks for being part of this community and conversation! Best Alene, moderator
deedeevee1 Member
I did this!! Came off all my headache meds and narcotic painkillers. What I discovered was that there was definitely some medication overuse or rebound headache coming from them. I'm still in pain daily but not as severe as when on all the meds.
Holly Harding Moderator & Contributor
<inline-mention username="deedeevee1" user-id="3718603"/> good to hear from you! And good for you for making your way through the process of coming off of opioids. That can definitely be an intense experience. So wonderful to hear that you’ve emerged on the other side with less pain and other symptoms. So glad you shared this with us. Warmly - Holly - <a href='http://migraine.com' target='_blank'>migraine.com</a> team

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