Do you have classic migraine with aura? If you experience aura, then take your Imatrex. If you don't have aura, then your going to have to figure out how you feel. What I mean is that you are going to have to get in tune with your body. Eventually you will figure out how you feel when a headache is coming on. It doesn't mean that you will catch it every time. I have had migraines for 11 years, and sometimes you catch them and sometimes you don't. If your not seeing a good headache specialist, then you need to find one. Half the battle to combatting your headaches is finding a good doctor who understands the problem. A good doctor will give you rescue alternatives if the Imatrex doesn't work. If you are taking Imatrex pills or nasal spray and it doesn't take effect quick engough, then you should try Imatrex shots. They have a quicker shock time to a headache. There are numerous other migraine drugs to try if Imatrex doesn't work for you. A specialist will help you to determine which one is best for you. There are also preventatives that will not only lessen pain, but also the frequency of your migraines. Hope this helps! I walk the road with the same pain.