O.K. Thank you for the additional information. She sounds miserable - as a teenager I struggled briefly with migraines, and so I know how she must feel. Fortunately, although migraines are common in teens, quite often these resolve spontaneously on their own over time. I only had migraines, on and off, for about a year, and this is not uncommon. Hopefully her's will as well.
Until then, however, there are a few things that you should do.
First, they need to be diagnosed conclusively as migraines. Typically they are very severe headaches, and can involve nausea/vomiting. Often, bright light or loud noises make the pain worse. From your description these do sound likely, but she should see her physician again, for new medication (since the imitrex isn't helping) and also just to make sure that migraines are exactly what we are dealing with here.
Treatment for migraines. First, over the counter meds can be helpful. Tylenol and advil can help, and some people like the special "migraine" formulations (these can include caffeine, which can help). So do not forget about these.
Imitrex can help. It needs to be taken as soon as a headache is suspected of coming on. There are injectable forms available as well, that help some better than the oral version.
Another medication used to help get rid of migraines is ergotamine and dihydroergotamine.
There are medications available, as well, to help with the nausea and vomiting, if they are required.
While all of the above are prescribed to help treat a headache that is starting or has started, there are also meds that can be taken prophylactically, to help avoid the possibility of developing a migraine.
This can include a number of different types of medications (most of which are also used to treat other disorders as well, but which were found to also help with migraine), including beta-blockers, tricyclic antidepressants, anticonvulsants, and even the calcium-channel blocker verapamil. So there are many medication options.
Some people also find that eliminating known triggers (like tobacco, alcohol, or caffeine) can help. Some complementary treatments, like oral magnesium supplementation, acupuncture, the herb feverfew, and riboflavin (vitamin B2) can also help. Finally, people have also found some relief with biofeedback, relaxation, chiropractic treatment, and osteopathy.
So all together, there are many options available for sufferers of migraine.
Your daughter is not being adequately treated, at all. She needs to return to her physician (she could also benefit from seeing a headache specialist - these are neurologists with special training and experience treating patients with headache) and ask for additional medications/suggestions. Trying another medication, or additional medications and other therapies, should help start the ball rolling to figure out what will work best for her.
If necessary, she can go back the ER as well. Migraines can be severely disabling, and if she needs more serious pain medication in the short term, until her physician's appointment, then that is another option as well.
I hope this helps. Please let me know if you have any further questions - I'm more than happy to help.
Take care, and I hope that she feels better soon - Dr. Fay
Edited by jcfay on September 30 2006 at 5:08 PM
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