So I still had to take Imitrex for that and it worked. In my 50's now I got vertigo without migraine. Neuro checked CT scan and it is normal for no tumors. I had a normal hearing, no ear problems.

My EEG's are still abnormal for migraine and so they tried Ciproheptadine and amitriptyline and that didn't work for the vertigo. It would throw me on the ground.

They gave me topiramate and it worked some but Trokendi XR worked. I take 1mg twice a day for anxiety and it works well for me. Never noticed helping migraines. Imetrex works but makes me so tired. Today I woke with a terrible migraine I got up took a Clonazepam 1mg and it went away I feel great. They have gotten progressively worse and I feel like I am constantly fighting them off and I've tried everything.

I have Relpax as a rescue drug and it works great, but I am only supposed to use it twice a week or else face rebound headaches. I asked my doc to prescribe Klonopin, mostly because I am under a lot of stress and I had read that it could help with TMJ disorder I grind my teeth badly and I have restless leg syndrome, Fibro and RA. What I didn't expect was for it to reduce my migraines considerably. I only had to take my Relpax 3 times last month! After that I literally had a migraine every 3 months like clockwork for almost 23 years.

I got so used to my "every 3 months cycle" that when I knew it was time for it to come around, I would actually warn school and work that I'd be needing at least 3 to 5 days off. I literally don't know anyone who gets them as bad as I do, I vomit and I'm extremely sensitive to light and sound and I literally can't get out of bed for 3 to 5 days.

They've caused me several jobs and several missed days of school. I've been prescribed over 20 different medications trying to find that worked but nothing ever did. Then I had a friend show me Clonazepam and ever since then, been migraine free! My doc prescribed it after the ativan wasn't enough anymore. I've been taking 2mg every 12 hrs still getting use to the side effects but overall it seems my migraines are very minor so far.

I've been taking less of my migraine meds, which I'm extremely happy about. Doctors put me on all types of pain and triptan class drugs and while they numbed it they didn't do much.

Propranolol Inderal can raise rizatriptan blood levels. Cimetidine Tagamet can increase zolmitriptan blood levels. Triptans should not be used in pregnant women and are not generally used in young children. What are the ergots? Ergots, like triptans, are medications that abort migraine headaches. Examples of ergots include ergotamine preparations Ergomar, Wigraine, and Cafergot and dihydroergotamine preparations Migranal, DHE Ergots, like triptans, cause constriction of blood vessels, but ergots tend to cause more constriction of vessels in the heart and other parts of the body than the triptans, and their effects on the heart are more prolonged than the triptans.

Therefore, they are not as safe as the triptans. The ergots also are more prone to cause nausea and vomiting than the triptans. The ergots can cause prolonged contraction of the uterus and miscarriages in pregnant women. Midrin is used to abort migraine and tension headaches. It is a combination of isometheptene a blood vessel constrictor , acetaminophen a pain reliever , and dichloralphenazone a mild sedative. It is most effective if used early during a headache; however, because of its potent blood vessel constricting effect, it should not be used in patients with high blood pressure, kidney disease, glaucoma, atherosclerosis, liver disease, or taking monoamine oxidase inhibitors.

What other medications are used for treating migraine headaches? Narcotics and butalbital-containng medications sometimes are used to treat migraine headaches; however, these medications are potentially addicting and are not used as initial treatment. They are sometimes used for patients whose headaches fail to respond to OTC medications but who are not candidates for triptans either due to pregnancy or the risk of heart attack and stroke. In patients with severe nausea, a combination of a triptan and an anti-nausea medication, for example, prochlorperazine Compazine or metoclopramide Reglan may be used.

When nausea is severe enough that oral medications are impractical, intravenous medications such as DHE dihydroergotamine , prochlorperazine Compazine , and valproate Depacon are useful. How are migraine headaches prevented? There are two ways to prevent migraine headaches: The best one can hope for is to reduce the frequency of headaches. What are migraine triggers? A migraine trigger is any factor that causes a headache in individuals who are prone to develop headaches.

Only a small proportion of migraine sufferers, however, clearly can identify triggers. Examples of triggers include stress, sleep disturbances, fasting, hormones, bright or flickering lights, odors, cigarette smoke, alcohol, aged cheeses, chocolate, monosodium glutamate, nitrites, aspartame, and caffeine. For some women, the decline in the blood level of estrogen during the onset of menstruation is a trigger for migraine headaches. The interval between exposure to a trigger and the onset of headache varies from hours to two days.

Exposure to a trigger does not always lead to a headache. Conversely, avoidance of triggers cannot completely prevent headaches. Different migraine sufferers respond to different triggers, and any one trigger will not induce a headache in every person who has migraine headaches. Sleep and migraine Disturbances such as sleep deprivation, too much sleep, poor quality of sleep, and frequent awakening at night are associated with both migraine and tension headaches, whereas improved sleep habits have been shown to reduce the frequency of migraine headaches.

Sleep also has been reported to shorten the duration of migraine headaches. Fasting and migraine Fasting possibly may precipitate migraine headaches by causing the release of stress-related hormones and lowering blood sugar. Therefore, migraine sufferers should avoid prolonged fasting. Bright lights and migraine Bright lights and other high intensity visual stimuli can cause headaches in healthy subjects as well as patients with migraine headaches, but migraine patients seem to have a lower than normal threshold for light-induced pain.

Sunlight, television, and flashing lights all have been reported to precipitate migraine headaches. Caffeine and migraine Caffeine is contained in many food products cola, tea, chocolates, coffee and OTC analgesics.

Caffeine in low doses can increase alertness and energy, but caffeine in high doses can cause insomnia, irritability, anxiety, and headaches. The over-use of caffeine-containing analgesics causes rebound headaches. Furthermore, individuals who consume high levels of caffeine regularly are more prone to develop withdrawal headaches when caffeine is stopped abruptly. Chocolate, wine, tyramine, MSG, nitrites, aspartame and migraine Chocolate has been reported to cause migraine headaches, but scientific studies have not consistently demonstrated an association between chocolate consumption and headaches.

Red wine has been shown to cause migraine headaches in some migraine sufferers, but it is not clear whether white wine also will cause migraine headaches. Tyramine a chemical found in cheese, wine, beer, dry sausage, and sauerkraut can precipitate migraine headaches, but there is no evidence that consuming a low-tyramine diet can reduce migraine frequency. However, some people seem to respond. Please go to our low-tyramine diet.

Monosodium glutamate MSG has been reported to cause headaches, facial flushing, sweating, and palpitations when consumed in high doses on an empty stomach. This phenomenon has been called Chinese restaurant syndrome. Nitrates and nitrites chemicals found in hotdogs, ham, frankfurters, bacon and sausages have been reported to cause migraine headaches. Aspartame, a sugar-substitute sweetener found in diet drinks and snacks, has been reported to trigger headaches when used in high doses for prolonged periods.

Female hormones and migraine Some women who suffer from migraine headaches experience more headaches around the time of their menstrual periods. Other women experience migraine headaches only during the menstrual period.

The term "menstrual migraine" is used mainly to describe migraines that occur in women who have almost all of their headaches from two days before to one day after their menstrual periods. Declining levels of estrogen at the onset of menses is likely to be the cause of menstrual migraines. Decreasing levels of estrogen also may be the cause of migraine headaches that develop among users of birth control pills during the week that estrogens are not taken.

What should migraine sufferers do? Individuals with mild and infrequent migraine headaches that do not cause disability may require only OTC analgesics. Individuals who experience several moderate or severe migraine headaches per month or whose headaches do not respond readily to medications should avoid triggers and consider modifications of their life-style.

Life-style modifications for migraine sufferers include: Go to sleep and waking up at the same time each day. Exercise regularly daily if possible. Make a commitment to exercise even when traveling or during busy periods at work. Exercise can improve the quality of sleep and reduce the frequency and severity of migraine headaches.

Build up your exercise level gradually. Over-exertion, especially for someone who is out of shape, can lead to migraine headaches. Do Not skip meals, and avoiding prolonged fasting. Limit stress through regular exercise and relaxation techniques. Limit caffeine consumption to less than two caffeine-containing beverages a day.

Avoid bright or flashing lights and wearing sunglasses if sunlight is a trigger. Identify and avoid foods that trigger headaches by keeping a headache and food diary. Review the diary with your doctor.

It is impractical to adopt a diet that avoids all known migraine triggers, however, it is reasonable to avoid foods that consistently trigger migraine headaches.

What are prophylactic medications for migraine headaches? Prophylactic medications are medications taken daily to reduce the frequency and duration of migraine headaches. They are not taken once a headache has begun.

There are several classes of prophylactic medications: Medications with the longest history of use are propranolol Inderal , a beta blocker, and amitriptyline Elavil , an antidepressant. When choosing a prophylactic medication for a patient the doctor must take into account the drug side effects, drug-drug interactions, and co-existing conditions such as diabetes, heart disease, and high blood pressure. Beta blockers Beta-blockers are a class of drugs that block the effects of beta-adrenergic substances such as adrenaline epinephrine.

By blocking the effects of adrenaline, beta-blockers relieve stress on the heart by slowing the rate at which the heart beats. Beta-blockers have been used to treat high blood pressure, angina, certain types or tremors, stage fright, and abnormally fast heart beats palpitations. They also have become important drugs for improving survival after heart attacks. Beta-blockers have been used for many years to prevent migraine headaches. It is not known how beta-blockers prevent migraine headaches.

It may be by decreasing prostaglandin production, though it also may be through their effect on serotonin or a direct effect on arteries. Beta-blockers generally are well tolerated.

They can aggravate breathing difficulties in patients with asthma, chronic bronchitis, or emphysema. In patients with who already have slow heart rates bradycardias and heart block defects in electrical conduction within the heart , beta-blockers can cause dangerously slow heartbeats. Beta-blockers can aggravate symptoms of heart failure. Other side effects include drowsiness, diarrhea, constipation, fatigue, decrease in endurance, insomnia, nausea, depression, dreaming, memory loss, impotence.

Tricyclic antidepressants Tricyclic antidepressants TCAs prevent migraine headaches by altering the neurotransmitters, norepinephrine and serotonin, that the nerves of the brain use to communicate with one another. The tricyclic antidepressants that have been used in preventing migraine headaches include amitriptyline Elavil , nortriptyline Pamelor, Aventyl , doxepin Sinequan , imipramine Tofranil , and protriptyline.

The most commonly encountered side effects associated with TCAs are fast heart rate, blurred vision, difficulty urinating, dry mouth, constipation, weight gain or loss, and low blood pressure when standing. TCAs should not be used with drugs that inhibit monoamine oxidase such as isocarboxazid Marplan , phenelzine Nardil , tranylcypromine Parnate , and procarbazine Matulane , since high fever, convulsions and even death may occur.

TCAs are used with caution in patients with seizures, since they can increase the risk of seizures. TCAs also are used with caution in patients with enlargement of the prostate because they can make urination difficult. TCAs can cause elevated pressure in the eyes of some patients with glaucoma.

TCAs can cause excessive sedation when used with other medications that slow the brain's processes, such as alcohol, barbiturates, narcotics, and benzodiazepines, e. Epinephrine should not be used with amitriptyline, since the combination can cause severe high blood pressure Antiserotonin medications Methysergide Sansert prevents migraine headaches by constricting blood vessels and reducing inflammation of the blood vessels. Methylergonovine is related chemically to methysergide and has a similar mechanism of action.

They are not widely used because of their side effects. The most serious side effect of methysergide is retroperitoneal fibrosis scarring of tissue around the ureters that carry urine from the kidneys to the bladder.

Retroperitoneal fibrosis, though rare, can block the ureters and cause backup of urine into the kidneys.

Backup of urine into the kidneys can cause back and flank the side of the body between the ribs and hips pain and ultimately can lead to kidney failure.

Methysergide also has been reported to cause scarring around the lungs that can lead to chest pain, and shortness of breath. Calcium channel blockers Calcium channel blockers CCBs are a class of drugs that block the entry of calcium into the muscle cells of the heart and the arteries. By blocking the entry of calcium, CCBs reduce contraction of the heart muscle, decrease heart rate, and lower blood pressure.

CCBs are used for treating high blood pressure, angina, and abnormal heart rhythms e. CCBs also appear to block a chemical within nerves, called serotonin, and have been used occasionally to prevent migraine headaches.

The most common side effects of CCBs are constipation, nausea, headache, rash, edema swelling of the legs with fluid , low blood pressure, drowsiness, and dizziness. When diltiazem or verapamil are given to individuals with heart failure, symptoms of heart failure may worsen because these drugs reduce the ability of the heart to pump blood. Verapamil and diltiazem may reduce the elimination and increase the blood levels of carbamazepine Tegretol , simvastatin Zocor , atorvastatin Lipitor , and lovastatin Mevacor.

This can lead to toxicity from these drugs. Anticonvulsants Anticonvulsants antiseizure medications also have been used to prevent migraine headaches. Examples of anticonvulsants that have been used are valproic acid, phenobarbital, gabapentin, and topiramate. It is not known how anticonvulsants work to prevent migraine headaches. Not all migraine sufferers need prophylactic medications; individuals with mild or infrequent headaches that respond readily to abortive medications do not need prophylactic medications.

Individuals who should consider prophylactic medications are those who: Require abortive medications for migraine headaches more frequently than twice weekly. Have two or more migraine headaches a month that do not respond readily to abortive medications. Have migraine headaches that are interfering substantially with their quality of life and work.

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