I need a preventative to reduce chronic daily headaches any good ones out there?

Hello it has been years since I have been on this site.  This site has always helped me.  I was so glad it was still up.

Question: I am a 62 years old and I suffer with chronic daily headaches with migraine thrown in as well. I was always told when I hit and bypassed menopause my headaches would improve. My headaches continue to get worse. My doctor just put me on a beta blocker since I was waking up with a headache every day.  It is Atenolol 100 mg. He told me to wait a month to see if it works. My month will be up on the 15th of Feb. I have noticed only that I am not waking up with a huge headache. It has not helped the headache situation at all. I am willing to keep going cause to my knowledge the beta blocker is not giving me any side effects. Butt.....

If I am still not getting any relief I was wondering if anyone can give me names of preventatives that have helped them? I have tried many years ago with no success. I know our bodies change with time. I gained a lot of weight over the last several years which has caused me other health issues. I just lost 25 pounds so any preventative that makes you gain weight I am not interested in trying. I have arthritis and must keep my weight down or I have trouble moving.

I take Imitrex but they only give you so many a month.

Any ideas or help I would really appreciate.

I am seeing names of people I used to see many years ago. I wish you all pain free days. If we could all just push a button and our headaches gone forever, that would be my wish for all of us.

Thank you all in advance,

kimsmom

Short answer: NO.

Long answer: I have tried every preventative out there and they all either did nothing or caused bizarre side effects or both. Individual responses vary however, so by all means try every thing you have not.

Things that do seem to work:

(1) supplements - natural progesterone and magnesium helped bring my frequency way down
(2) Botox works for many people ( but not for me)
(3) Cefaly - this has worked very well for me. My frequency and severity are way down. You need to use it every night for 20 minutes. No side effects besides making me sleepy so I use it before bed time.

I also started getting migraines in my mid 40's so I am sure peri menopause was involved. But finally getting through menopause did not get rid of them. I kept a food diary, and have eliminated all known triggers. If I watch my sleep and avoid really loud noise ( a trigger for me), and I keep up with the Cefaly I seem to be doing much much better (from 40% migraine days down to only a few minor headaches last month).

Good luck!

It'll all depend on what your doctor is comfortable with / commonly uses.  Although there are literally hundreds of headache & migraine treatment options, most doctors have a short go-to list.  Also, since responses to meds are so individual, its typically not that helpful to suggest anything in particular unless the patient has been through a long list of treatments and their doctors are stumped, so they want to bring in some suggestions.

I'd first see what your doctor suggests.  They may want to increase the dose (if you aren't at the max and its well tolerated) or give it more time, or else they have another idea in mind.  I've found often meds aren't trialed long enough or at a high enough dose, so you may want to double check there isn't any benefit to giving it a longer trial.

I've had the worst luck with anti seizure meds (significant side effects with them all), but Topamax is probably top of the list as far as the most likely to help headache patients.  However, it has a higher than average rate of side effects.  It should be trialed for 3 months after tapering up (which may take a month or two), so there isn't much likelihood of immediate relief.

I'm a fan of beta blockers and calcium channel blockers.  The side effect rate is low and they are well studied.  I'm currently on Verapamil for episodic migraine (it hasn't touched my constant 10 year headache unfortunately, but I wasn't expecting it to) and haven't had any side effects.  So, if avoiding side effects is a top priority / you had bad experiences in the past with other meds your doctor suggests, another beta blocker could be an option.

Anti depressants are another good category.  They can often also help other related symptoms such as depression, anxiety, insomnia, etc.

If your condition is quickly worsening, it may be time to pull out all the stops.  Ask to try something specifically to break this cycle (such as oral steroids, or ideally, be hospitalized for IV meds).  Typically only a doctor in a headache clinic associated with a hospital would be able to support hospitalization though (its never been an option for me for example).

You could ask to be started on more than one preventative at a time to hedge your bets...this doesn't necessarily need to be more than one oral med (although that is an option, such as meds from different classes), but possibly a med plus an alternative therapy or injections (nerve blocks or Botox) or elimination diet.

You can also ask to try other abortive (as needed) meds so you have something to take when you don't have enough Imitrex.  If your insurance doesn't give you enough to take 2 or 3 a week (which would be 8-12 a month, typically the safe amount to limit the risk of rebound), or if you require more than 1 in 24 hours so you run through them quickly, and your doctor is ok with it, you can also check into paying cash for extra, or even better, have your doctor submit a quantity override so insurance will pay for it.

I found my insurance covered more than one Triptan in a month (but oddly enough wouldn't allow me to fill one more than once).  The prescribing information says not to mix the types within 24 hours, but when I was going through a lot of them, being able to get 9 Imitrex plus 6 Amerge was really helpful.

Also check if you can either be prescribed a higher Imitrex dose and split them, or if you are already getting 100mg, if you really need the full dose.  I found I only need half the 100mg pill most of the time (my doctor prescribed the 100mg from the get go for whatever reason), so that doubled my doses per month from 9 to 18, more than I would use.

Generic Sumatriptan, especially if you shop around, may be affordable, if your doctor won't do a quantity override or it gets denied.  There are also non-triptan options that have the potential to be helpful (such as NSAIDs and muscle relaxers).

Ensure you are seeing a neurologist who is a true headache specialist, in that they see headache patients all day every day.  Most of the time they are a neuro who sees headache patients as only a small part of their practice and don't have a real expertise and interest in complex chronic headache patients.

Even if you are happy with your doctor and they continue to have new ideas, getting another opinion doesn't hurt.  It may take awhile to get in with a top headache specialist, so getting the process started may be a good idea.  Every doctor I've seen has had something different to say.  Hang in there!  Best wishes.

That is great knowledge written by tortisgirl. You will have to find one that works for you.. Clonidine worked for me quickly. .1 3 x day.

Maybe a calcium channel blocker with the beta blocker. The VA won't supply 100 of Atenolol. I take 50 mg.

I hope you find something soon.

Thank you so much everyone for your replies. I have never heard of Cefaly before and I would like to try it. I looked it up and it cost over $300.00. That is out of the question right now as I am on a single budget. I will ask my doctor about it and if the insurance will pay I am wanting to try it.

My doctor was going to put me on Verapamil but it was not going to sit well with the stantin he was going to put me on. I have tried several stantins and this one worked great with no side effects. I am now told my insurance will not pay unless there is a prior authorization from my doctor. The women who called me to tell me this also said their office did not do prior authorizations. I was at work and could not talk with her but told her I could not believe that! I am going to the doctor on Monday so we shall see about that one!!!

The Atenolol has done nothing to help me. I am not looking for a huge difference. Just getting 25% better is worth it to me.

I will let you all know what the doctor comes up with for me. He is a good doctor but his staff is horrible. He joined a "group" and they sent him his staff. I have never gotten good service with them at all. errrr

Thanks again everyone!

kimsmom

Check into insurance coverage for Cefaly...I'd suggest calling up your insurance directly, as your doctor won't know about your insurance specifically.  If they cover it, you'd likely need a "prescription" from your doctor for it (both for purchase and insurance reimbursement).

A lot of doctors now are refusing to do any prior authorizations for prescriptions.  It can take up literally hours of their staff's time for each one doing the back & forth with the insurance and gathering the info from the patient's medical records they request, and they don't get paid for it.

If you are having multiple problems with your doctor's office (like if your insurance requires a prior auth for many meds and they won't do them), it may be time to look for a new one.  Ideally you'd have a good primary doctor and headache specialist (neuro who only sees headache patients).

I try to deal with all my doctor's staff as little as possible, even though they are pretty decent, as its easy for misunderstandings to happen, and the phone tag is annoying.  I usually make an appointment to deal with thing directly with the doctor as much as possible, even for example when my doctor said I could have just called about a simple med change.  Best wishes.

Only two preventatives have worked for me.The first is Lisinopril, which is a medicine for high blood pressure.This may or may not be right for you, but you might want to discuss it with your doctor. I took it for about four months or so and didn't have one migraine the whole time. Unfortunately, I have other health problems and couldn't take it any more.

I know Cefaly is expensive, but for me, it's been worth every penny, and if something happened to mine tomorrow, I'd buy another one in a New York minute. Please do a search on "Cefaly" this board. I have posted a number of times about Cefaly, including a year's worth of my stats. It reduced my migraines from 3 a week to 3 a month and sometimes fewer.

I don't know if your health insurance will cover Cefaly, but the Cefaly company used to/will refund your money if you use it for a month without results. (You have to use it correctly, though, meaning every day, whether you have a migraine or not.) Please see the web site for this info, because the refund doesn't apply everywhere.

The only other thing I might say worked for me somewhat is biological estrogen and progesterone, which I took for several years while going through menopause. They seemed to reduce the number and intensity of migraines, so I had fewer and they weren't as bad. Still bad, but not as bad. Just be sure to use the bio-identical hormones, not the Premarins and other stuff.

Best of luck.

Hi I am not sure if this is the type of advice you are looking for, but what works for me:

None of the preventatives ever worked for me at all.  Even if they had worked, I always had a ton of side effects.

The only thing that worked for me is diet change - my most successful changes including very low sugar and low carb.  If I limit to food items that have 5g of sugar per serving or less, and 30g of carbs per serving or less, I have a huge difference in migraine frequency.  From everyday, to 3-4 per week.  Big difference.. also need to avoid MSG/yeast extract and food colors with numbers (red 40, yellow 5, etc), or else I get a very severe migraine.  As a result of this diet I also lost weight (15% of my total weight), which you may be looking for as a plus as well.

I saw someone else mention, and I will agree, to cut your Imitrex pills with a pill cutter.  Start with 100mg and cut in half, take that for awhile if successfull then try cutting 1/4.

Now with my diet changes I take 1/8 of an Imitrex successfully when I get a migraine.  Eliminated the problem of insurance only giving one package per month.  Good luck.

Migraine is usually diagnosed by typical symptoms. There is no test to confirm migraine. Also, with some uncommon or rare types of migraine such as ocular migraine, tests are sometimes done to rule out other causes of these symptoms. I recently read a blog post of Dynamic physiotherapy in Burlington which discusses a few ways to effectively prevent migraines instead of learning to suffer through the pain that includes
1.Over the counter medicines and prescriptions
2.Check the weather
3.Have a regular eating schedule
4.Keep a headache journal
5.Say no to stressful situations
6.Try to get a good amount of sleep
7.Exercise but don’t overdo it
8.Botox
9.Acupuncture/Massage Therapy
10.Avoid Loud Noises & Bright Lights

I hope you find something soon.

Thank you again for your replies. I think I will try Cefaly. I was told it is sold at Costco's. Any help this can do for me will be welcomed. I get chronic daily headaches with migraine so I guess I should bite the bullet. Wish it was not so expensive but if I get relief it will be well worth the cost.

I welcomed everyones input into my situation. Thank you all!

kimsmom

There a few categories of treatment described at this site:

https://migraine.com/migraine-treatment/

Some can reduce the frequency of migraines, some reduce the severity. It doesn't seem that the same treatment works for everyone, and from what I've seen it requires a lot of trial and mostly failures. Keep in mind if you try multiple things at once you won't know which one worked and which one didn't.

Personally I've found that magnesium and vitamin B2 has reduced the severity such that I haven't had a blindingly painful migraine in years. I tried Topamax (topiramate) and it made the episodes extremely mild, but the side effects were like living in a fog. The only thing that really helped was regular moderate outdoor jogging (light exercise didn't help, heavy exercise made things worse, jogging on a treadmill didn't help). Candesartan is a BP medicine that my doctor says has worked well in trials but didn't help me. Atenolol helped me a bit, but not much. Escitalopram helped my daughter considerably, but not as much for me.

I've also found 5-HTP (available at Costco) works somewhat well as an "early abortive" - if I take it very early when I first feel a migraine coming on, most of the time it will stop it in an hour or so. If it doesn't work, I take generic Sumatriptan.

You can get various generic Sumpatriptans from healthwarehouse.com at a pretty good price. I've found the efficacy varies greatly by brand; Dr Reddy was easily the least effective. Watson was the best, though it has gotten more expensive. The Watson documentation showed that the efficacy of 50mg was not much less than 100mg, and sure enough I've found the same.

I use Ranbaxy, as it is good for the price, with two Advil. This is similar to Treximet, which is extremely effective but about $75 a pill and my insurance only reduces that to $30/pill.

I can't say any of this will help for you. Everyone is different. It took me years to figure all these out; it's important to keep trying. There may not be a single holy grail.

You need to be careful taking medications more than recommended. Too frequent 5-HTP can cause diarrhea. Too frequent Sumatriptan can render it ineffective (way too frequent of either of these can cause Serotonin syndrome, put you in the hospital or kill you).