Help in Columbia - Preventative and pain medications that actually work?

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    How in the world will a person that "rides the edge of the coin" like me when it comes to migraine find a neurologist, preventative medications and pain medications that actually work without head "pressure" or rebound headaches.  Some of my triggers are actually good for a person and I have limited or removed the rest.  I have spoken to my G.P. and he says there is no one in my area that prescribes narcotics for migraine pain relief.  I have been on Topamax, Lamictal, verapamil, Verelan and others for prevention that quit working after a time.  I have tried Imitrex, Migranal, Relpax, Midrin, Zomig and Frova and others. These either gave me rebound headaches or other side effects that affected my daily life.  My triggers include tomatoes, garlic, chocolate, malt beverages, aged chesses and meats, stress (of course), less than 6 hours of sleep or more that 8 hours of sleep. Help. I don't know where to turn, I live in Columbia South Carolina and have been dealing with migraine for almost 26 years now. Wendy.

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    Dear Wendy;


    Sadly, your question shows your issues to be quite similar to those of many, many Migraineurs. Yes, you have several food triggers that you need to avoid, but at least you can avoid Migraines triggered by those. Those, at least, are avoidable, manageable triggers. It's great that you've figured them out. Doing that saves you a great many Migraines.


    There's really no "of course" when it comes to stress as a Migraine trigger. There's still some controversy, but we hate to see anyone accept that stress is a trigger without at least trying to see if they encounter triggers during stressful times that they either don't encounter at other times or they're only triggers when the body is stressed. The International Headache Society has removed stress from their list of Migraine triggers and put it on their list of exacerbating factors -- things that make us more susceptible to our triggers. Many people have sworn stress was a trigger for them until they kept a very detailed diary for a few months. More information in Is Stress a Migraine Trigger?. We hope you'll thoroughly investigate this as we think we do ourselves a real disservice by thinking stress is a trigger for us and not looking closely for other triggers during stressful times.


    Medications having given you rebound headaches is evidence that you need to continue working to find an effective preventive regimen. That's far better for a Migraineur's health than  taking abortive medications or pain relievers so frequently. Anyone who has more than three Migraines a month needs to be taking something for prevention. There's growing evidence that Migraine is a progressive brain disease. A recent study showed that Migraines can cause brain damage, and that people with three or more Migraines a month are more susceptible to this damage. For more information, see Is Migraine a Progressive Brain Disease? and Yes, Migraines Can Cause Brain Damage.


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    As for narcotics, newer research indicates that prescribing them for Migraines can make matters worse rather than better. It's been shown that any use of barbiturates or opioids and frequent use of triptans and NSAIDs are associated with increased risk of transformed Migraine. For more information on this, please take a look at Transformed Migraine - Risk Increased by Some Medications.


    The best suggestion we can offer is for you to seek care with a Migraine 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.


    Don't lose hope about preventives. There are now over 100 medications and supplements that can be used for Migraine and headache prevention. The frustration of trying to find what works for us can make it seem as if we’ve tried it all, but with so many possible preventives, it’s literally impossible to have tried them all. See Migraine preventive medications – too many options to give up! for more information.


    Good luck,
    John Claude Krusz and Teri Robert



    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.


    If you have a question, please click HERE. Accepted questions will be answered by publishing the answers here. Due to the number of questions submitted, no questions will be answered privately, and questions will be accepted only when submitted via THIS FORM. Please do not submit questions via email, private message, or SharePost comments. Thank you.


    Please note: We cannot handle emergencies or diagnose via the Internet. Please do not ask us to diagnose; see your physician for diagnosis.


    We hope you find this general medical and health information useful, but this Q & A is meant to support not replace the professional medical advice you receive from your doctor. For all personal medical and health matters, including decisions about diagnoses, medications and other treatment options, you should always consult your doctor. See full Disclaimer.


    Page copy protected against web site content infringement by Copyscape© Teri Robert and J.C. Krusz, 2009.
    Last updated February 3, 2009.


     migraines headaches health migraine headache and migraine

Published On: February 03, 2009