Barb,

Both amitriptyline and nortriptyline are tricyclic antidepressants as Casey said. However, they are older medications and are being used less and less in the treatment of Migraine. There are newer antidepressants that are being used more now because they seem to be more effective for Migraine and they have fewer potential side effects.

Neurontin is a neruonal stabilizing agent, aka antiseizure drug. The drugs in this class have been showing great promise for Migaine prevention. Part of what happens in the brain during a Migraine is that overactive neurons start firing in a wave across the brain. One of the primary functions of this type of medication that make it good for Migraine prevention is the function of calming electrical activity in the brain.

Maxalt works in the brain to actually stop the Migrainous activity when a Migraine occurs. There are now seven medications in this family. If Maxalt doesn't work for your husband, it's worth trying the others. Pleae note, however, that Maxalt and other meds taken when a Migraine occurs should not be taken more than two or three days a week because of their potential to complicate matters by causing medication overuse hadaches, aka rebound. You can read about that in Medication Overuse Headache - When the Remedy Backfires.

It's really impossible to say if this is a "good combination." People's bodies react differently to medications, so the only way to know if a combination is "good" is by trying it.

If these medications don't work for your husband, there are still many to try. Once he and his doctor find effective preventive medications, they should reduce both the frequency and severity of his Migraines and help him stay out of the ER.

Good luck,

Teri