Can treatment reduce my migraine headache?

Question

Hello doctor,

I am a female, 46, with migraines since college, currently averaging 12 headache days a month despite preventive medication.

My question is simple:

Can someone at 46 reach fewer than 5 migraine days monthly with treatment?
Sometimes I wonder whether my expectations are unrealistic or whether I should keep pushing for better control.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Migraine is a brain that is hypersensitive and keeps sending out signals to produce headaches. We aim to not only relieve the pain during an attack but also to reduce the number of headaches.

For prevention, we usually start with daily medications in low doses and titrate them slowly based on response and side effects:

Amitriptyline.
Topiramate.
Valproate.
Propranolol.

These medicines usually take four to eight weeks to show good benefit, so regular use is important.

If migraines still continue despite adequate treatment, we now have newer, advanced options such as calcitonin gene-related peptide antagonist injections, which are newer migraine-specific injections.

Greater occipital nerve block injections are small injections around the back of the head and neck that can help with resistant migraine or severe flare-ups.

Along with medicines, lifestyle measures are equally important:

Regular sleep.
Hydration.
Never miss a meal.
Stress Management.
Limiting excess screen exposure.
Identifying trigger foods or activities.

Most migraine patients do very well with the proper combination of treatment and follow-up care.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.