My biggest issue has been not whether I should change, but whether my body will continue to respond to the medication with positive results. Some medications, and this is particularly true in the triptan category, have worked once, and once only. Others have worked for a longer period, and then stopped. If I had enough of an arsenal of rescue meds for the 3-5 migraines I live with on a weekly basis, I could keep a longer rotation going between the different meds that have, at one time or another worked for me. As it is, I barely have 2 workable meds at any given time, and that is not enough to keep me out of the rebound headaches, or for one of the meds to stop working altogether. Very rarely will I be able to go back to that drug for re-use. If I am careful, and just put up with a higher level of pain on a day to day basis, I can eke more use out of regimen by not using the rescue med when I have a migraine below a certain level until I am so exhausted from the pain, I give up and take something.
The profalactic meds I take are also changed from time to time when the rescue meds seem to be failing. I just went through a change by going off one, and cross-titrating two others, went through 6 weeks of hell, and I am still not sure that the new prophylactic med is going to work. It is causing a lot of nausea, and I am feeling tired, no appetite, and a few other things, but still trying to give the change a fair go.
My auras have seemed to go away, though and that is something.
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Very interesting! Thanks for writing about this.
One thing I've discovered that's true for me as I've learned more about living with chronic migraine is that sometimes I have to give on triptan a break and can then return to it down the road. Imitrex injections are one of my go to treatment meds, but I somehow tend to develop a tolerance to them that goes away with a break.
You're welcome, Diana! Yeah, I think triptans, like most meds, can get "tired" and need a rest.
Teri