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What Are The Treatment Options For Chronic Migraine?
Question: I suffer from chronic migraines that began in 6th grade. I am now 55 and have tried everything on the market through tthe years. I moved to Delaware from XXXXXXX last XXXXXXX I was under the care of a neurologist who prescribed imitrex and Norco 10-325. Imitrex as the first line of defense, followed by Norco if I get no relief. I get 3-5 migraines per week. I am having trouble finding a doctor either in the Rehoboth Beach area where I live, nor in New Castle where I work who will prescribe these medications. Any idea on what I can do.
Brief Answer:
Try new medications and prevention measures
Detailed Answer:
Hello XXXX,
As you have mentioned that you were diagnosed as a case of migraine in childhood, what is the present situation.
Migraine is a primary headache with or without aura. Classically it is associated with throbbing nature , hemicranial distribution, nausea, vomiting, photophobia, phonophobia, increased on exertion , relieved on rest and medications .
The treatment is divided into two parts:
1) Acute symptomatic therapy: Sumatriptans, rizatriptan, nazitriptans can be taken. Pain killers like acetaminophen , naproxen with or without domperidone.
2) Prophylaxis therapy: Beta blockers- Propranolol
calcium channel blocker: Flunarizine
amitriptyline
Topiramate
valproate
The decision to give prophylaxis is based on increased number of attacks with headache on most days of month.
The newer drugs like topiramate, valproate are also very effective and can be tried by you.
Prevention of headache attacks can be done by life style modification, timely food , proper sleep, avoiding coffee and chocolates. Refraining from direct sunlight.
All these can help you.
Availability of drugs over the counter is an issue and has to be solved by you.
some online stores provide medications by courier with proper prescription of a doctor.
Hope you find the answer helpful.
wishing you good health.
Regards
Dr Neeraj Kumar
Neurologist
Try new medications and prevention measures
Detailed Answer:
Hello XXXX,
As you have mentioned that you were diagnosed as a case of migraine in childhood, what is the present situation.
Migraine is a primary headache with or without aura. Classically it is associated with throbbing nature , hemicranial distribution, nausea, vomiting, photophobia, phonophobia, increased on exertion , relieved on rest and medications .
The treatment is divided into two parts:
1) Acute symptomatic therapy: Sumatriptans, rizatriptan, nazitriptans can be taken. Pain killers like acetaminophen , naproxen with or without domperidone.
2) Prophylaxis therapy: Beta blockers- Propranolol
calcium channel blocker: Flunarizine
amitriptyline
Topiramate
valproate
The decision to give prophylaxis is based on increased number of attacks with headache on most days of month.
The newer drugs like topiramate, valproate are also very effective and can be tried by you.
Prevention of headache attacks can be done by life style modification, timely food , proper sleep, avoiding coffee and chocolates. Refraining from direct sunlight.
All these can help you.
Availability of drugs over the counter is an issue and has to be solved by you.
some online stores provide medications by courier with proper prescription of a doctor.
Hope you find the answer helpful.
wishing you good health.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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