The Massive World of Combination Treatments for Migraine

It has been reported that some doctors are still telling their migraine patients that they are “out of options”. With the number of migraine treatments available today, no patient should hear that (unless they are very, very, very old).

Some of the confusion perhaps comes from the idea that there are only a handful of mainstream drug treatments for migraine. But there are many options in each category, many possible dosages, even more than one type of a single medication. And there are helpful medications that don’t fit in these few categories. And there are many good treatments that aren’t even “drugs”.

I mean “good” in the sense that they have good scientific evidence behind them, and a good track record of significantly helping migraine patients.

But perhaps there is also confusion because of “combination treatments”. Once you’ve gone through dozens of treatments, you still have all kinds of combinations. Imagine if there were 30 migraine treatments you wanted to try – how many combinations are there? Hundreds, of course, if you try two at a time. But what if you try 3 at a time? And what if you give every combination a decent try?

If you try each treatment for 3 months, and never take a break from age 12 to age 112, you can try 400 treatments. There are more than 400 possible treatments for migraine, if you include combinations, different doses, and different versions of medication. WAY more.

For those readers new to migraine, you need to know: Many patients have found significant or complete relief using a combination of treatments.

For example, Emily cut caffeine from her diet, takes magnesium, and uses a common preventative medication. Meanwhile, Jacob uses biofeedback, massage, and a common abortive when needed (which is now very rarely).

But with hundreds or thousands of possibilities, how do I choose?

• You educate yourself. Thanks for visiting this site, where you will find hundreds of articles to help you.
• You keep track of symptoms. What if one treatment cuts your attacks by 25%? That’s not enough – but combined with something else…
• You keep an open mind – but too open. In other words, don’t limit yourself to certain kinds of treatment. Then again, don’t try everything. Look for treatments with good evidence behind them.
• Get a good doctor – better, a team of health professionals (read What’s Wrong with Me? for help on this). That doesn’t mean they all know each other. It may mean that you have a good migraine specialist, a good physiotherapist, and a good chiropractor. A health professional will help you find treatments that have the best chance of working for you. As much as possible, make sure your doctors know your personal and family medical history.
• Make sure your doctor is willing to work with you over the long term. Neurological diseases like migraine take time to treat. You do not want a doctor who will give up on you.

I hope that we hear less and less of “you’ve tried everything”. It’s not true, it’s not helpful, and it needs to be a part of migraine history, not migraine present.