How do I manage migraines when injections stop working?

Question

Hello doctor,

I have been getting migraines since my late 30s, and for a good 8 years, the monthly injections were basically a lifesaver for me. However, for the past six or seven months, they just are not working the same way anymore. I am still getting three to four bad migraines a month, even with the injections.

How does a 58-year-old manage migraines after years on injectable treatment that worked when suddenly it does not, and you are kind of back to square one again?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I can understand why this feels so discouraging. When a treatment has given you years of good control, having migraines return can make it seem as though you are back where you started.

The good news is that you are not out of options. It is worth seeing your neurologist or headache specialist because a change in your migraine pattern after years of stability often calls for a reassessment. They may look for factors such as medication overuse from frequent pain relievers, changes in sleep, stress, hormone levels, new medical conditions, or other triggers that could be reducing the effectiveness of your current treatment.

Sometimes better control can be achieved by changing to another drug within the same class, changing to another preventive treatment, or by combining therapies. There are also newer migraine treatments for prevention and treatment of acute migraine attacks that might be appropriate if your current injections are not giving you enough benefit.

In the meantime, maintaining regular sleep, staying well hydrated, eating consistent meals, exercising as tolerated, and keeping a headache diary to track attacks and possible triggers can provide valuable information for your doctor.

Because you are 58, if these headaches are significantly different from your previous migraines, become suddenly severe, or are associated with weakness, vision loss, confusion, difficulty speaking, or other new neurological symptoms, you should seek urgent medical evaluation right away.

Even though this setback is frustrating, many people are able to regain good migraine control after adjusting their treatment plan, so there is good reason to be hopeful.

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

Thank you.