Hey guys! I have been suferring from severe migraine headaches for 10 years, often 5-7 days a week, and have recently discovered all of these forums. I wanted to leave my own story and advice about things because I have found ways of controlling them, and to give everybody hope! I was able to get into medical school with these headaches - you guys can do anything if you put your mind to it! I also have some info on Cymbalta, which I recently started taking.
First off, let me tell you that I have learned from my neurologist that about 90 percent of migraines come from the neck. Therefore, if the neck is treated, often the migraines will go away. I had CT scan and X-Rays done, read as normal by ortho, but my pain management and neurologist doctors both neck abnormalities. Ironically enough, these abnormalities were more visible in X-Ray than CT Scan. My neurologist sent me to an excellent physical therapist (please go by recommendation - there are a lot of quacks out there) who I went to twice a week. I also started doing neck exercises in the morning and at night on a foam roll that stretches the back. Within weeks of doing these exercises daily, along with PT, there was an immense amount of relief.
I also noticed that I get migraines when there are large sugar fluctuations in my system. Therefore, I try not to go a long time when I'm eating, and I don't eat tons and tons of carbs unless it's a holiday. If you eat a lot of carbs, your sugar will spike, then fall, and that's a common cause of migraine.
Exercise also really helps. Even with a headache, if you go on a treadmill (or an elliptical), even very slowly, and do some very light weights with your neck supported, your muscles will strengthen and you will start feeling much better.
Now, on to medical treatments:
BEWARE OF TOPAMAX. It may help, but it causes severe memory loss in many people, some of which, after long term use, you may never regain. I started taking it when I was pre-med, and my science grades went from As to Cs. I couldn't understand anything I read, and eventually I couldn't even remember what TV show I had watched after turning off the TV. I got off of it and regained my memory, and never come near it anymore.
I also took Lamictal for about 2 or 3 years, it did very little for me but I stayed on it hoping it would work. Mostly, I noticed that when I worked out more my migraines lessened, but the Lamictal itself did very little.
I also got Botox injections - they did not help at all. Doctors get reimbursed big bucks for them, so that's why they recommend them. They are not very effective, which is why insurances don't pay most of the time. There have been very mixed, often negative study findings, although it has worked for some patients on a case to case basis.
I also have an anxiety disorder, very bad panic attacks. I had been on Lexapro for many years. Upon seeing a new psychiatrist, she, along with my other doctors, recommended Cymbalta. Why not kill two birds with one stone? I have been on Cymbalta for 3 months now. I recently increased my dose to 90mg. I definitely feel side effects, but it has eradicated a majority of my migraines. I feel the start of a migraine but it never comes on fully; I feel like a different person. Here are the side effects I experience: I cannot fully empty my bladder, and I have to pee a lot more often. It's really not that big of a deal, it just takes an extra minute of my day. I have random wakings in the middle of the night but those have gotten better and I sleep pretty well. I feel more fatigued then usual, which has been my most significant issue since I'm a pretty high energy person, but I drink a cup of coffee maybe twice a day and exercise and my energy level goes up. When I up my medication, I get weird fits of anger sometimes, but they seem to subside as my body gets used to the dose. Ultimately, what will determine whether Cymbalta will help you is (1) how your body responds to it, obviously but also (2) what your migraines are coming from. Since migraines are caused by nerve pain, and Cymbalta helps nerve pain, it will obviously help migraines. Very often that is the case, which is why it has been such an effective treatment. Apparently, 60 mg should be the optimal dose for migraines, as it causes the least side effects with the most medicinal effects. My dose is higher for my anxiety purposes (I take 90).
Last thing - neurologists often don't tell you this, but SEE A PAIN MANAGEMENT DOCTOR! They are brilliant, many of them, and deal with pain on a regular basis. They are familiar with far more medications than neurologists, but most importantly, they do procedures such as nerve blocks which can help you a great deal. I get nerve blocks in my occipital lobe and cervical spine, and they work wonders. They sound scarier than they are - they are injected with a local anesthetic so there is minimal pain, the procedure is relatively quick (15-30 minutes), and the results are amazing without having to take pills!
So guys, my hugest advice to you is to try to take as few medicines as possible - I had one renowned neurologist put me on Verapamil (a BP med) along with low doses and Nortyptalene (an old school antidepressent) which lowered my BP so much and caused me such a terrible headache that I was admitted to the hospital for 3 days from the ER and had to be on IV morphine, which was horrific. A great as-needed medication I take now is Depakote, if I'm having huge episodes of severe migraines, it usually stops them in 2 or 3 days. I also take Relpax as needed when I develop a migraine, along with either 2 Tylenol or 4 Advil. If you have stomach problems and can't take anti-inflammatories like Advil, there is a new mediaction called Vimovo that mixes Aleve (Naproxen) with a heartburn Zantac-like medicine. It works incredibly and doesn't hurt your stomach.
The first doctor who actually helped me significantly was the doctor who took me off all the medications, recommended diet and exercise, and physical therapy, and my pain management doc who recommended Cymbala and nerve blocks. Good luck and if you have any questions, don't hesitate to ask! Hope this helps! :)