Q. What do I do if I’m having recurring migraines this week? My sumatriptan typically wipes them out, but it’s only worked for about 10 hours and then the migraine returns. I’m not supposed to keep taking the Imitrex, but I really don’t know what to do. I can’t look at a computer. I can’t get any work done. It’s awful. What can I do?
A. The first consideration would be to consider a different triptan than sumatriptan. It has the shortest half-life of all the triptans and there are many patients whose headaches recur within 24 hours. Frovatriptan has the longest half-life and may be the answer for you.
Another option is to try a higher dose of sumatriptan or a second dose after several hours.
Some people find combining a triptan with an NSAID provides more sustained relief.
If you are having 4 or more days per month of migraine, then you should consider prophylaxis (preventive) therapy. There is much information available from NHF on alternative and complementary therapy for migraine prevention. As for acute treatment, some have found taking a dose of Magnesium (glycinate – 400 mg or oxide 500 mg) improves their treatment success.