Hi, There are many medicines other than topomax and verapamil, that give good results in migraine prophylaxis, like amitryptiline, propranolol, dosulepin, flunarizine etc. In my opinion, a combination of amitryptiline and propranolol should give excellent results. Imitrex and nerve blocks can provide relief once an episode has started but cannot prevent the occurrence of the next episode. The other things that you can do is to identify and avoid triggers of your migraine episodes, like certain foods, excessive exercise, fatigue, bright lights, noise. Hormonal changes also act as a trigger and so, it is possible for your reproductive problems or hormonal medicines to be related to your migraine. Hope this helps you. Best wishes.