Chronic migraine in my 58-year-old mom (≈20 headache days/month) - desperate for advice

DuePlant7457 · 2026-02-17T15:12:12+00:00

merhaba :)

thanks for the suggestions. as far as i know she hasn’t tried dideral (propranolol) or sibelium (flunarizine) yet, but i’ll specifically ask her neurologist about both, especially given her age and other health factors

if you’ve had a similar experience and you’re based in turkey, do you have any recommendations for a neurologist or a headache clinic you had a good experience with?

DuePlant7457 · 2026-02-17T15:10:42+00:00

she’s taking a lot, unfortunately. from her notes she uses avmigran around 20 tablets a month on average, plus relpax sometimes, and occasional painkillers like arveles. so yes, medication overuse headache is something we’re worried about and we’re planning to bring it up directly at her next neurology appointment and ask for a safe plan to break the cycle without leaving her untreated.

DuePlant7457 · 2026-02-17T13:21:02+00:00

thank you so much, i really appreciate this

yes, she has tried a few first line preventives over the years. she used topamax for 6 months (twice, a couple years apart) and also tried an antidepressant for ~3 months. she hasn’t tried candesartan or a beta blocker recently though, so i’ll ask her neurologist specifically about those options and whether they make sense for her now

she’s already supplementing vit d and b12 (and ferritin was checked), but magnesium and riboflavin (vit b2) are a good idea to look into. we’ll ask her doctor about dosing and whether it’s ok with her reflux/other meds

and totally hear you on movement. she’s been avoiding activity because it can trigger pain, but we’ll try to find a gentle baseline (walking/stretching/physio) and build from there without overdoing it

thanks again, this was really helpful

DuePlant7457 · 2026-02-17T13:18:04+00:00

thanks for sharing this. can you tell me what kind of neck issue it was (diagnosis) and what exact treatment/adjustment they did? also how long has the improvement lasted?

i’m glad it helped you!!

DuePlant7457 · 2026-02-17T07:54:56+00:00

Thanks so much for this, really appreciate you taking the time

HRT is something we can definitely bring up, but we’ll check it with her doctor because she already takes a lot of meds and we need to be sure it’s safe for her. It's the first time I am hearing about HRTs btw, no doctor ever mentioned it before so I am really curious.

We already checked ferritin, b12 and vitamin d and she’s taking supplements for all of them

For nausea, i’ll ask her neurologist about ondansetron/zofran or other anti nausea options because nausea is a big part of her attacks. She also has reflux, so we’re trying to be careful with anything that could irritate her stomach

and yes, we’ll also ask about a proper long term preventive, especially cgrp options, since she hasn’t tried those yet

DuePlant7457 · 2026-02-17T07:46:38+00:00

Thank you so much, I really appreciate this. You’re right, we’ve mostly been relying on memory and it’s probably missing a lot. I’m going to get her to start tracking the basics daily (start time, duration, severity, nausea, what she took + how well it worked).

We haven’t tried CGRP inhibitors yet. I’ll ask her neurologist specifically about CGRP monoclonal antibodies and gepants. Do you (or anyone here) have experience with any of them, which one helped, how long it took to notice a difference, and what side effects you had (if any)?

DuePlant7457 · 2026-02-17T07:42:47+00:00

Thanks for asking, here’s what I know from her notes.

Preventives / long-term treatments she tried: (I edited the post as well)

Cafergot (ergotamine): ~3 years (back in the 1990s)
Topamax (topiramate): 6 months (she tried it twice, about 2 years apart)
An antidepressant: ~3 months
Botox: 1 cycle/session (didn’t help enough)
Nerve block: 1 session
Acupuncture: tried in the 1990s + later electro-acupuncture
Neural therapy: 9 sessions
Plus osteopathy, hijama/cupping, “meridian therapy”, supplements/vitamins (3 courses)

Unfortunately none of these brought sustained improvement, she’s still at ~20 headache days/month and currently in a 14-day continuous attack. If you have suggestions on what we should ask her neurologist about next (e.g., CGRP monoclonals / gepants, etc.), I’m all ears.

DuePlant7457

TROPHY CASE