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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Persistent Acute Migraine

I keep having head aches. I went to my doctor and they prescribed me a medicine for an acute onset of a migraine. And the medicine works sometimes. However if I wake up with a migraine then nothing helps it but a trip to the emergency room and shots. At the er yesterday the shots they gave me did not even make my head feel 100 percent better. But it was better however I still have a bit of a headache today. The er doctor did give me a preventative to take twice a day and I started that yesterday. And the ct I had showed no mass or bleed. However I am so tired of my head hurting. What can I do?
Fri, 12 Dec 2014
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Neurologist 's  Response
I read your query and I understand your concern.

Migraine is a chronic headache for which two types of treatments are given, the acute attack treatment and preventive one if the attacks are frequent (2 or more per month).
You don't say what they've given you for the attack. Usually common antiinflammatories like Ibuprofene are tried but they have to be taken as early as the attack is installing. Another option are ergot derivatives like ergotamine. Once the attack is established though usually only triptans (zolmitriptan, sumatriptan etc) can abort it. So if you haven't been prescribed them discuss their use in future attacks with your doctor.
Regarding preventive treatment, you have started it only yesterday so you have to try it for some weeks to evaluate its effect, it has not been given to you for the current attack, so be patient. The aim is not necessarily to make the attacks disappear but to reduce their frequency. If the treatment you've just started is not effective enough don't despair and give up, there are different preventive drugs with different mechanisms of action, different classes can be more effective in different patients.
So try to be patient and try to have a neurologist follow you up regularly to re-evaluate your treatment in time.

I hope to have been of help.
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Suggest Treatment For Persistent Acute Migraine

I read your query and I understand your concern. Migraine is a chronic headache for which two types of treatments are given, the acute attack treatment and preventive one if the attacks are frequent (2 or more per month). You don t say what they ve given you for the attack. Usually common antiinflammatories like Ibuprofene are tried but they have to be taken as early as the attack is installing. Another option are ergot derivatives like ergotamine. Once the attack is established though usually only triptans (zolmitriptan, sumatriptan etc) can abort it. So if you haven t been prescribed them discuss their use in future attacks with your doctor. Regarding preventive treatment, you have started it only yesterday so you have to try it for some weeks to evaluate its effect, it has not been given to you for the current attack, so be patient. The aim is not necessarily to make the attacks disappear but to reduce their frequency. If the treatment you ve just started is not effective enough don t despair and give up, there are different preventive drugs with different mechanisms of action, different classes can be more effective in different patients. So try to be patient and try to have a neurologist follow you up regularly to re-evaluate your treatment in time. I hope to have been of help.