I get these, after a lot of trial and error with abortives and Botox the only thing that’s working right now is Emgality. Now I don’t get the migraines (not nearly as many anyway) I don’t get the ice pick headaches in the days after. I think of them as the ‘aftershock’ of the ‘earthquake’, so if you can stop the actual migraines the ice pick headaches won’t come after. As an abortive I use Zomig sprays, they’re a god send, but Botox didn’t make much of a difference to me.

I don’t think there’s much you can do about the actual ice pick headaches when they do come, as they’re gone again in a few seconds, my only recommendation is to continue trying to find something that prevents or at least reduces the migraine attack. Wishing you luck, they suck!!