12/3/07 #3 - Can an abortive work when migraine never seems to stop and start?

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  • Full Question:
    I've been having daily chronic migraines for several months. I can't remember the last day when my head didn't hurt. Right now, I'm seeing a neurologist who prescribed Amerge for me, and I tried taking it when a low pain day was transforming into a bad pain day. I had a really bad reaction. Now she is giving me Midrin, but it says to take it at the start of a migraine. Can you use an abortive drug when your migraine never seems to stop and start? Migraine Chick.





    Dear Migraine Chick;


    In your situation, it's unlikely that a typical abortive is going to stop the cycle you're in. What's more likely to break the cycle is a steroid dose pack or an IV infusion. There are several types of medication that can work in an IV infusion to break a cycle -- steroids, antinausea medications, neuronal stabilizing agents, even magnesium sulfate. You can find more about this in IV Treatment of Refractory Migraines.

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    You probably already know about medication overuse headache, aka rebound, but in case you don't -- taking pain medications or Migraine abortives more than two or three days a week can make matters worse by causing medication overuse headaches. Medication overuse is frequently an issue in chronic Migraines and headaches. See Medication Overuse Headache: When the Remedy Backfires for more information on this issue.


    If your neurologist isn't more helpful, it may well be time to seek the care of a Migraine specialist. If you need help finding one, there's a link below.


    Good luck,
    John Claude Krusz and Teri Robert


    If you need to find a headache and Migraine specialist, please see our listing of patient recommended specialists.


    Another good source of information and support is our forum. To post to the forum, you'll need to register, even if you're already registered on the main section of our site. You can use the same email address and password for both registrations.



    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.


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    © Teri Robert and J.C. Krusz, 2007.

    Last updated December 3, 2007.

Published On: December 03, 2007