I am going to the doctor next week to talk about Migraine Prophylaxis. I have moderate-severe migraines 1-4 times a week.

I have Maxalt and it works well, but I run out before the end of the month, which TERRIFIES me...

I am wondering what people have tried, and what worked.

Hi BadWolf .... I live with Relpax - another Triptan like Maxalt. AND my dear doctor prescribes TWO boxes per month. I get twelve tablets instead of six.
Won't your doctor do the same?
If he does, will your insurance pay for it? The precious Triptans cost as much a gold.

Have you tried any migraine prevention meds? I was on Topamax for years and it did wonders for me! It drastically cut down the frequency of my migraines. The only migraine med I could tolerate that helped when I did get a migraine, was Amerge. I have since developed an allergy to it

Try what Wren said, ask your dr to prescribe more. Majority of insurance companies will only cover about 9 pills every month. When I switched over to my husband's insurance, BCBS, they would cover more per month...I was shocked!

Good luck,
Nanc

Welcome BadWolf,

Ask your doctor to put in an override for Maxalt to your insurance company. (Mine did, and when I needed them, I was getting 30/month). The good news is that Maxalt is now available generically, though it may still take a few more months until we see any appreciable price reduction (usually about 6 mo. after going generic).

People can make suggestions about what worked for them prophylactically, but everyone is different, and the only way to find what will work for you is trial & error. Possibilities include medications, supplements, and diet (avoiding food triggers).

migraine prophylaxis

There is hope. I've gone from >15 per month (definition of chronic) to about 4 per month with a combination of diet & myofascial release trigger point therapy.

Also, see if you can find a headache/migraine specialist (one whose practice is limited solely to migraines). That made a huge difference for me. I bounced between 4 neuros who claimed they treated them, but really didn't know squat compared to the headache guy.

Doc

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

There seem to be many different causes of Migraine but every doctor I've seen has told me that the biological process that is widely thought to lead to the symptoms is a spasming of a particular blood vessel that runs from the spine/neck to your head (sorry if you already know that!).

Some people can easily highlight the causes of their migraines and do pretty well at managing them, e.g. hormones or foods like nuts/chocolate can be triggers.

Some, including myself, suffer them simply through stress and being both mentally and physically tense (hence the link to the neck area). I only suffer a handful of migraines a year but mine are terrifying - numbness on one side, completely incoherent, often sick, can't see. I usually manage to avoid them through exercise and meditation, as I've yet to try a medication that prevented them.

Some people I guess just get them and finding a root cause or trigger can be hopeless.

You're lucky you've found something that works for you - is there any reason you can't get a repeat prescription to keep stocked up? Would the doctor rearrange your appointment if you tell them you're running too low? There's also a chance that the medication will still have a positive effect after you run out as it'll still be in your system for a short time

Starting with the last first... Maxalt (rizatriptan) and other triptan abortives have very short half-lives (2-3 hrs), which is why they're taken at short intervals. Not likely to still be around the next day or longer.

When this thread was started (last August) Maxalt was still under patent, and very expensive ($14 to $17 per tablet, and it could take up to 3 tablets to knock out a migraine). Insurance companies put limits on how much they would pay for each month. (I understand BadWolf's plight very well—I was in a nearly identical situation.) If you got more migraines than they decided you were allowed to have, you were out of luck. Doctors can put in requests for overrides on those monthly allotments, but you have to have a doctor willing to go to bat for you, and an insurance company that can see reason (good luck! )

Maxalt has since come off patent, but the price is still high (and allotments low) and likely will be for the next few months at least.

Doc

Hello,
I have had this weird feeling in my right eye and no that a migraine is coming. It's one that looks like a lightening bolt and it zips across my eye in a zigzag shape. Today I had a big one at 12:45pm lasted 20 min. 20 min. later a small one in the same eye., again lasting 20. min. In all total today 4 in 4 hours. I just laid my head down shut my eyes and sort of tried too sleep. I am 60 yrs. old and this is the first time i have had so many at one time during a day. I have had them start in left eye and wander over too the right eye and then it was gone and done with, and man oh man the headache that follows that.
Now I did have them in my early 20's and the doctor gave me some blue & white capsule that seemed too help and a couple of trips to the chiropractor. And by gosh they were gone for 40+ yrs.
The darn thing came back in Jan.2014 only a couple of times., but today was the weirdest of having that many.
Has anyone out there have these kinds of migraines.

Yes, Stretchismyname
I had this symptom you are describing, the one with the zigzag light in one eye, 3 or four time.
I will describe my symptom the fallowing way: I had had headaches on and off for some months, but never went to the doctor for it, and was never diagnosed with Migrane headache. I had also had 2 episodes of vertigo, described as the ceiling moving above me.
One day I noticed a visual disturbance in my vision in the left eye. I had a ring of zigzag bright light on the outer aspect of my left eye visual field. I could see through the hole in the middle of it. Mine also lasted about 20 - 30 minutes. The second time I had it, I noticed the ring got bigger and bigger and finally dissapeared out towards the left of the visual field.
I went to my opthomologist. He added up the symptoms and sent me for a stat MRI of the brain, and called me later with the result. I had a cerebral aneurysm, and he already had called a neurologist for me.
Now, this aneurysm was noticed only incidentially, so I was glad it had been noticed in time( it did not rupture) and I had the aneurysm emboliced in time. It could have been there for some time.( they are often asymptomatic)
So this probably had nothing to do with the aneurysm part. BUT.----I was now told that this symptom with the visual disturbance was MIGRANE AURA. I went to a neuro opthomologist who told me that one can have this AURA MIGRANE without actual pain. He said this is calle a ancephalic migrane.
I have since had migrane in the form of a sharp, short lasting ICE PICK pain
that comes and goes. When it comes, it is momentary only and then comes back with another "jolt" in an hour or so, and then goes on for the day and goes away for a while. Weeks at the time. No medicine has helped me.
Until now< I have developed Neuropathy, and the neurologist has put me on Amitripthyline for the nerve pain. He said it would also help the migrane.
But I have now a multiple multiple magnification of prior headache, and I am awaiting further medical help and diagnosis.

I am now wondering, and I will try to research this, if, and what is the connection between Migrane/cerebral aneurysm/vasculitis/hypertension ???

Does any one have any experience in theese combined/related?? conditions??

Thanks for reading.

Hi Stretch, welcome.

In the 1960s, my mother was treated for migraine with phenobarbital.

I agree that definitely sounds like migraine aura. It's not unknown to have migraines early in life, then they stop, and may come back decades later. Often, migraines are painful but benign, but they can also be symptoms of something more serious.

Please see your doctor about this asap. Nowadays there are much better and safer medications, and doctors who specialize solely in migraines.

Doc