Hi BadWolf,

What has helped me for prophylaxis, in the past, is gabapentin 1200mg /day divided into 3 or 4 doses, as regularly spaced as possible. This is off label I think and you'd have to check with your insurance if it would be covered, but I think it would.

I've tried Topamax before and it seemed to work at 100mg /day but I had to suspend d/t side effects. Some may have been a coincidence, so I may try it again if I need something.

Depakote is a first-line prophylactic med and helps a lot of people.

Without prophylaxis, my first-line treatment is Zomig (zolmitriptan). If I don't take it in time, I sometimes have to chase it with an NSAID. I know what you mean about needing more than 6 ... I've had months with 18/30 days of headache.

If I don't take the Zomig soon enough, it usually doesn't work. Sometimes I can get by with indomethacin or ibuprofen, but for the really bad ones I have tramadol (addictive -- I do not use it often).

Sorry you suffer with these beasties. Good luck with the override for more Maxalt -- you should be able to get as much med as your doctor says you need to have. Good luck finding a good prophylactic too. Sometimes that is really the best route... it's so much easier just not getting all those headaches.

Take care, and welcome to Neurotalk!

waves