Full Question:

I have been suffering with migraines since I was nine years old. I am now 46 years old. I have had periods in my lifetime that I have been migraine free, but not for long. They seem to be getting worse as I get older. I do suffer from Pre-Menstrual migraines as well as other migraines during the month and have been on Frova and Zoloft for many years and see a neurologist regularly.  My question is: How much Frova is too much Frova? I take 18 pills a month, mostly before and after my period. [A preventative schedule of Frova pills that originally I was part of a migraine study at a migraine clinic in Michigan.] I am tired of migraines controlling me and interrupting my life. My quality of life is suffering. I have tried everything from Beta blockers, Ace Inhibitors, anti depressants, blood pressure, anti-seizure meds and Toporol. There are so many I have forgotten them all!  There is one med I have not tried, Periactin........ What are your thoughts on this medication? Thank You! Wendi.

Answer:

Dear Wendi;

Your first question of how much Frova is too much is a bit more complex since you use it prophylactically for menstrually triggered Migraines. It's suggested that the use of Frova and other triptans be limited to 10 days a month in order to avoid medication overuse headache (MOH). For more information on this, please see Medication Overuse Headache - When the Remedy Backfires. Also, since you do use Frova as a prophylactic agent, discuss with your doctor how much Frova is too much Frova for YOU.

On the preventive side, Periactin is quite effective for some people, but not, of course, for all. The good news here is that there are now over 100 medications and supplements that can be used for Migraine and headache prevention, so it’s literally impossible to have tried them all. See Migraine preventive medications – too many options to give up! for more information.

If your doctor isn’t able to help you, it may well be time to consult a Migraine and headache specialist. It’s important to note that neurologists aren’t necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.

Best regards,
John Claude Krusz and Teri Robert

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If you need help finding a Migraine and headache specialist,
 visit our listing of Patient Recommended Specialists.

About Ask the Clinician:

Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.