hi mam/sir,you have not yet tried all the modalities of treatment for migraine.so relax and please dont give up.there is non pharmacological therapy that worked in about 40-50% patients.it is CERENA TMS(transcranial magnetic stimulator).it is meant for patients >18yrs.it relieves pain due to
migraine headache with aura.but it must be put only once in 24hrs.coming to medical management,as you have already tried ergots and NSAIDs,you can start taking triptans in combination with NSAIDs or
opioid analgesics.triptans are also available as
transdermal patch,
SUMATRIPTAN IONTOPHORETIC TRANSDERMAL SYSTEM.it is effective in patients with or without aura.sumatriptan in combination with
naproxen sodium is available as TREXIMET.many of my patients had very good results with above medication.
mode of administration: triptans are to be taken early during a migraine.only maximum of 2 doses a day are allowed.they shouldnt be used for >3 days a week.
caution :triptans should not be taken in the following conditions.
1)history of coronary
artery disease,cerebrovascular events.
2)it should not be co-administered along with MAO-A inhibitor drugs like
tranylcypromine,isocarboxazid,seligilene etc.
hope my clarification is upto your expectation.any further queries,please write to us.it would be my pleasure to be of any help to you.thank you.take care.bye.