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    Try dietary changes, exercise, other preventive and abortive drugs, Botox
    nyheadache posted:
    These are typical chronic migraine headaches. While I cannot give specific advice to anyone without seeing them first, there are some general ideas to consider. We always begin with non-drug approaches. Regular aerobic exercise (starting slow and building up the speed and the duration), biofeedback, avoid caffeine (coffee, tea, soda, Excedrin, Fioricet), try a low-carb and then a gluten-free diet, for two weeks each to see if it makes a difference. Several supplements have been shown to prevent migraines: magnesium, vitamin B2, CoQ10, feverfew, boswellia, omega-3s, and other.
    There are many preventive drugs besides Topamax, which is not my 1st, 2nd or 3rd choice because of its cognitive side effects. Discuss with your doctor trying atenolol, candesartan, nortriptyline, tizanidine and other preventive drugs, although all of them have different potential side effects.
    One of the most effective and very safe options for chronic migraines is Botox injections. Botox is approved by the FDA for chronic migraines, although insurance companies usually insist that you try and fail at least 2 preventive medications before they agree to pay for Botox.
    As far as abortive drugs, you may want to try all 7 triptans to see which one gives best relief with fewest side effects. These are: sumatriptan (Imitrex), rizatriptan (Maxalt), zolmitriptan (Zomig), naratriptan (Amerge), eletriptan (Relpax), frovatriptan (Frova) and almotriptan (Axert - temporary not available).
    Migralex doc
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