Neurologist said there’s not really more option. Is it right?

My headache before trying these medications were not as bad as now, and was able to cope with Tylenol .

I tried following. Sumatriptan Prednisone Rizatriptan Toradol shot Ubrelvy.

I took ubrelvy yesterday and had very bad headache and nausea . The neurologist tell me to still give another try to ubrelvy as there are no more options

With another ubrelvy, I feel like I’m having a very tight headband around my head. Feels like everything is hopeless. Just so upsetting. And now, excederin or Tylenol isn’t helping at all to cope with migraines

in migraineby keesiy

99%

View all comments

Lower-Potential3743

162

Here is a list of different preventatives and abortives. NOTE THIS IS NOT A COMPLETE LIST. 1. Beta-blockers: - Propranolol - Metoprolol - Atenolol

Antidepressants:
- Amitriptyline
- Nortriptyline
- Venlafaxine
Anticonvulsants:
- Topiramate
- Valproate
- Gabapentin
Calcium Channel Blockers:
- Verapamil
- Flunarizine
CGRP (Calcitonin Gene-Related Peptide) Inhibitors:
- Erenumab
- Fremanezumab
- Galcanezumab
- Eptinezumab
Serotonin Receptor Agonists:
- Methysergide (less commonly used due to side effects)
ACE Inhibitors/ARBs:
- Lisinopril
- Candesartan
Botulinum Toxin (Botox):
- For chronic migraines
Nutritional Supplements:
- Magnesium
- Riboflavin (Vitamin B2)
- Coenzyme Q10
Herbal Supplements:
- Butterbur
- Feverfew
Non-Medication Approaches:
- Cognitive Behavioral Therapy (CBT)
- Biofeedback
- Acupuncture

Here is a list of different abortives:

Triptans:
- Sumatriptan
- Rizatriptan
- Zolmitriptan
- Eletriptan
- Naratriptan
- Almotriptan
- Frovatriptan
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):
- Ibuprofen
- Naproxen
- Diclofenac
- Aspirin
Ergots:
- Ergotamine
- Dihydroergotamine (DHE)
Anti-nausea Medications:
- Metoclopramide
- Prochlorperazine
- Ondansetron
Combination Medications:
- Sumatriptan/naproxen (Treximet)
- Acetaminophen/aspirin/caffeine (Excedrin Migraine)
CGRP (Calcitonin Gene-Related Peptide) Receptor Antagonists:
- Ubrogepant
- Rimegepant
Lasmiditan:
- A serotonin 5-HT1F receptor agonist used for acute migraine treatment.
Steroids:
- Prednisone or dexamethasone (used occasionally for severe attacks or status migrainosus)
Opioids (generally avoided due to risk of dependency and limited effectiveness):
- Codeine
- Tramadol
Other Pain Relievers:
- Acetaminophen (Paracetamol)

These are the many options we have and I am missing ALOT and I mean ALOT more. You are not out of options. I strongly suggest you find a neurologist that is willing to not give up on you and fight along with you.

Fuzzy_Dragonfruit344

There are also nerve blocks and an infusion med (can’t remember the name) and vagus nerve stimulators that help stop migraines and block pain. I get a combination of treatments to keep mine at bay. One treatment may not be enough for you OP. I get a form of Botox called Xeomin (regular botox didn’t help me) every three months. I take a once a month Ajovy injection and use Nurtec as an abortive (and sometimes a two week, high dose prednisone taper if it is a bad migraine that won’t stop). I also use dissolvable Zofran for severe nausea. Triptans and ergots do not work for me. None of the other categories of meds this person mentioned work for me and I have literally tried them all. I have tried all of the CGRPs. Aimovig didn’t do much, Emgality made them worse, Ubrelvy did nothing. There’s a new one called Zavzpret, but it didn’t do anything for me. Ajovy in combination with Botox controls mine by about 85-95%. Nurtec gets rid of them in a hour or so, but never longer than two. When I do get breakthrough migraines they are MUCH less severe than they used to be. There’s an atypical drug called Compazine that they use in the ER as part of a migraine cocktail to stop status migraines and it actually works really well for me. I was diagnosed with chronic intractable migraines. I was having migraines 28-31 days out of the month. I literally went through about thirty meds before I found a combination that works for me. I’ve heard good things about the vagus nerve stimulators, but I can’t use them because I have epilepsy.

Medical marijuana is also an alternative option. I used that when I had no other relief. There’s a good strain called great white shark that was specifically created for chronic pain patients. It also helps control nausea and helped me to fall asleep when I was in severe pain. I used that until I found my current treatments because I had nothing else that helped. It didn’t completely get rid of the pain, but it did help me not want to scoop my eyeballs out with a grapefruit spoon. It also helps with the anxiety and depression that comes with being in constant pain.

Your neurologist is bonkers if they think you only have five options. There are new migraine meds coming out all the time nowadays.

I would highly recommend looking for a different neurologist, preferably one that specializes in migraines. If you can’t find one of those, definitely look for a different neurologist. I hope you are able to find a solution and start feeling better soon. ❤️‍🩹

keesiy

Hey, I’m curious how were you or your neurologist able to figure out that one brand of Botox did not work?

Fuzzy_Dragonfruit344

I tried it for over a year with little to no results. I actually had to tactfully push to try something else but the difference between regular botox and the one I get now is night and day. From the very first injection I could feel the muscles relaxing. A lot of people have that experience with regular botox, I never did. I don’t know why it works better for me, but I tend to be really sensitive to medication, so maybe that has something to do with it.