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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Remedy For Migraines

i am suffering from migraine,Headache is occuring daily.I have seen many doctors and had taken medicines for more then 1 yesr.i am suffering from migraine since 10 years and the problem is getting worse.i am taking painkillers and vasograin.please help
Fri, 23 Jun 2017
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Neurologist 's  Response
Hello:

You are suffering from chronic migraine. First of all, you need all the non-pharmacologic treatment strategies as any other migraine patient: identify and avoid triggers (common triggers are fasting, heat, alcohol, cured meat, and smoked fishes, aged cheeses, some odors like gasoline or cigarette smoke), avoid sleep deprivation and dehydration. I suggest doing some exercise; avoid heat or direct sunlight to the head (use a hat or umbrella).

If now you are not taking any prophylactic medication, you could start right now. There are good options as topiramate, amitryptiline, propranolol, magnesium, riboflavin, melatonin, or candesartan. If you are taking one of those, maybe botulinum toxin injection (with OnabotulinumA) would be the right choice for you.

For the pain, medications as Ibuprofen, naproxen or acetaminophen, would be helpful. I usually don not use ergotamine with my patients. I prefer triptans as zolmitriptan, eletriptan, almotriptan, for the acute attack.

I suggest writing a migraine blog (to identify your own triggers, response to treatment, and attacks frequency and characteristics), also consulting with a pain and headache neurologist for a complete assessment.

I hope this helps, if you have any doubt before your appointment, please let me know.
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Suggest Remedy For Migraines

Hello: You are suffering from chronic migraine. First of all, you need all the non-pharmacologic treatment strategies as any other migraine patient: identify and avoid triggers (common triggers are fasting, heat, alcohol, cured meat, and smoked fishes, aged cheeses, some odors like gasoline or cigarette smoke), avoid sleep deprivation and dehydration. I suggest doing some exercise; avoid heat or direct sunlight to the head (use a hat or umbrella). If now you are not taking any prophylactic medication, you could start right now. There are good options as topiramate, amitryptiline, propranolol, magnesium, riboflavin, melatonin, or candesartan. If you are taking one of those, maybe botulinum toxin injection (with OnabotulinumA) would be the right choice for you. For the pain, medications as Ibuprofen, naproxen or acetaminophen, would be helpful. I usually don not use ergotamine with my patients. I prefer triptans as zolmitriptan, eletriptan, almotriptan, for the acute attack. I suggest writing a migraine blog (to identify your own triggers, response to treatment, and attacks frequency and characteristics), also consulting with a pain and headache neurologist for a complete assessment. I hope this helps, if you have any doubt before your appointment, please let me know.