My doctor diagnosed me with hemicrania continua after a trial of indomethacin. The problem is the indomethacin is tearing up my stomach something terrible, and my doctor doesn’t have any ideas about what else to try. Do you know of other options? I’m really hoping you can help. Thank you, Viola.
You’re in a tough situation. But yes, there are other options for hemicrania continua that you can discuss with your doctor. In 2014, research presented at the American Headache Society’s annual scientific meeting looked at a number of other treatments for hemicrania continua. Their research showed the best evidence for Botox. Gabapentin (Neurontin), celecoxib (Celebrex), and verapamil were also helpful, but less so than Botox.
Topiramate (Topamax) and melatonin were also tested in this research, but neither produced any therapeutic results. You can read more about that research in Treating Hemicrania Continua When Indomethacin Can’t be Used.
Hemicrania continua is, as you know, difficult to treat and still not well understood. We hope this information helps you and your doctor find a treatment that helps without the negative side effects of indomethacin. Another thought - If the indomethacin was very successful, you and your doctor may want to discuss trying it in combination with a proton pump inhibitor such as Nexium or Prevacid or an H2 blocker such as Tagamet or Zantac.
Thank you for your question,
Dave Watson and Teri Robert
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© David Watson and Teri Robert, 2016.
Dr. David Watson is a UCNS certified migraine and headache specialist and the director of the West Virginia University Headache Center. Dr. Watson takes a special interest in migraines, cluster headaches, and tension-type headaches. He strives to stay up-to-date on current research and treatments and regularly attends continuing medical education conferences. “Dr. Dave” is also very active in the migraine community, taking part in and leading advocacy efforts to benefit the entire community. He is the founder and chairman of the board of Runnin’ for Research, a nonprofit organization that helps interested patients and doctors set up races in their areas to raise research funding for headache disorders. He’s also a regular participant in the Alliance for Headache Disorders Advocacy’s “Headache on the Hill” event and is co-secretary of the American Headache and Migraine Association. You can follow Dr. Watson on Twitter.
Teri Robert is a leading patient educator and advocate in the area of migraine and other headache disorders, and has been writing for the HealthCentral migraine site since 2007. She is a co-founder of the Alliance for Headache Disorders Advocacy and the American Headache and Migraine Association. She received the National Headache Foundation’s Patient Partners Award for “ongoing patient education, support, and advocacy,” in 2004 and a Distinguished Service Award from the American Headache Society in 2013. You can find links to Teri’s work on her web site and blog and follow her on Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.
Do you have questions about Migraine? Reader questions are answered by UCNS certified Migraine and headache specialist Dr. David Watson, and award-winning patient educator and advocate Teri Robert. Questions may be submitted via our submission form. Accepted questions will be answered by publishing the answers in our Ask the Clinician column. For an overview of how we can help and questions we can and can’t answer, please see Seeking Migraine and Headache Diagnoses and Medical Advice.