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Dear Andee,   One thing that can be difficult about medictions for Migraine prevention is that nearly all of them are prescribed off-label. If you look them up, you will not find them said to be indicated for Migraine prevention. There are over 100 medications in use for Migraine and headache prevention, but only four of them have actually been approved by the FDA for an indication of Migraine or headache prevention. Amitriptyline has been prescribed for Migraine prevention for many years, and is quite effective for some people. It has been approved for depression in children aged nine and older.   We can't diagnose, but we can share information that you can discuss with your nephew's doctor. One thing that comes to mind given that his started with a rash and on a specific day is the possibility of new daily persistent headache. You can find more information in New Daily Persistent Headache - The Basics.   Is he taking something daily or near daily to relieve the headache? If so, a big part of his problem may well be medication overuse headache (MOH), aka rebound. See Medication Overuse Headache - When the Remedy Backfires for more information on this.   Obviously your nephew needs help. Keep in mind that neurologists are not necessarily headache and Migraine specialists. I suggest that your family find a good specialist for him. This can make a world of difference. 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.   I know you and your family are going through a rough time. If any of you would like some additional support, come join our discussion forum. You'll need to register again once there because it's a separate membership database, but you can use the same member name, email address, and password that you used here. You can find our forum at http://forums.healthcentral.com/discussion/migraine/forums.   Good luck, Teri