What do you do if the triptans don't work?

I don't get migraines very often, but when I do they hang around for days - basically until they feel like they want to go away.

The one I have now is onto its fourth day. When it first came on I took one Imigran and that worked for a few hours but then the pain came back. I took another one before going to bed and that held the pain off until mid-morning the next day. I took some ibuprofen to get me through the rest of the day, which took the edge of the pain but didn't make it go away. Yesterday the pain was getting really bad and I took another Imigran but within about 20 minutes the migraine got worse - I started to get an aura, and then again later on in the afternoon. I think that was just a coincidence and not caused by the Imigran, but either way it didn't make the pain any better! I've been in bed ever since, although I'm currently functioning (just about) thanks to some more ibuprofen which has dulled the pain again.

I know, from past experience, that this one will probably just disappear of its own accord for no obvious reason. But I'd like to know if there is anything else I can do to speed it along on its way. My GP only seems to offer me triptans. We've talked about preventative medication but I don't really get them often enough (once every month or two) to make it worthwhile. I just want a reliable way to make a migraine go away! Any suggestions? Thanks!

25 Replies

  • Try a different triptan! Imigran didn't work for me either but Zomig did for a few years till it wore off and now I'm on Maxalt Melt. When the Maxalt stops working I shall probably go back to the Zommig again. Just because one particular triptan isn't working doesn't necessarily mean that particulare drug group isn't right for you. Good luck. :-)

  • Yes try a different triptan but it is normal that the migraine comes back after a few hours. Or try a very high dose through injection (Immigran).

  • If 2 triptans havent worked a further one for that migraine wont work. Dr Elrington at the NATIONAL MIGRAINE CENTRE, London taught me that if you can, you are best to let the migraine take its course and not medicate it. Especially if you try ibuprofen that just takes the edge off the pain it seems to prolong the length of the migraine.

    The MIGRAINE CENTRE are worth looking up and the best advice i got there was if you can manage to cope with the pain level without medication thats the best thing you can do.

  • Can I ask if you thought the Migraine Centre was worth the cost? When I have migraines I can't move without being sick and am stuck in bed for up to a week. I often go without medication because it doesn't help enough but it is stopping me from working so I'm looking for a better solution!

  • I found they were worth their weight in gold. I'd been struggling with trying to get a good solution for my migraines on the nhs and so I invested in going to the clinic.

    It was a good investestment as well and enabled me to get life back on track again. Definitely go and have an appointment with them, your migraines truely are destroying your life. Good luck! Let us know how you get on!!

  • There is a possibility that you might be getting medication overuse headaches. I use maxalt melt as well, but I restrict them to 2, on 2 occasions in a month. Because I'm on preventative treatment that reduces the headache intensity I can usually tough out a migraine unless there is something vital I must do.

  • It is true people respond differently to different triptans. We often see patients taking the correct medication but in an ineffective way ie. at the wrong time/dose etc. Come to see one of our doctors to discuss your options. You are right a preventative may not be for you, so its about finding the right acute rescue and managing your triggers. 900mg of dispersible aspirin taken with full sugar coke is a favourite among some of our doctors - but as the others on here suggest never take acute rescue more than 15 times a month (or 10 with triptans)!

  • I feel so sad for you as sometimes my migraine pain makes me feel like taking ALL the pills in my cupboard, and to hell with the consequences! yet other times -providing I do not have anything important to do I can manage with taking paracetomol 1000mg followed in 1 hour by 600mg ibuprofen -- then I try to stretch the time before pain relief to 5 hours.... ( but -NOT recommended-I do sometimes take paracetomol before the recommended time lapse) after the 1st dose..

    This does not stop the droopy eyelid and weepy eye, or the blind spots.

  • I'm new to this forum so I was pleased to see someone refer to a weeping eye as a symptom of migraine. In recent years my eye has been watering considerably along with the headache and my nose starts to run as well. I've never seen it on any list of symptoms. I don't usually bother taking painkillers as they don't seem to work but when I couldn't sleep last night because my head was throbbing I got up at 4 am and took 4 standard ibuprofen tablets (800mg total). Amazingly it worked and I slept through till 9am. Of course it's not something I can recommend but I wonder if it is safe to do this occasionally.

  • Remember if you are taking ANY brufen protect your stomach!! eat something (if possible) or drink a glass of milk (again if possible)-- If you find brufen truly helps and you are worried about your stomach lining then visit your GP as there is medication which will protect it.

  • Try soluble aspirin, stick to stated dose, take with food, they work by thinning the blood, I believe. I'm on 50mg of amytriptline and 200mg of topamax daily and still have various different painful migraines, through the month and aspirin works - not what they recommend, but, if you have no other issues, and check with your GP, try it.

  • Hi, I'm new to this forum but desperate for help! I noticed that I am on the same medication as you altho only 100mg Topamax, my migraines are getting so severe and almost daily it's ruining my home life :-(when really bad I have to take dihydrocodeine, then diazepam to knock me out but my dr won't refer me to specialist..she just keeps topping up my pills..now I have more migraines than ever and problems with circulation... can anybody give me advice?stop the pills?NEVER feel normal again?

  • Thanks for your answers. I've actualy been to the National Migraine Centre and they were very helpful in terms of helping me identify triggers. Unfortunately one of my big ones seems to be stress, and it's very difficult to manage that particularly seeing as we're understaffed at work at the moment. They also told me about the disolvable aspirin and full-fat coke trick...unfortunately I can't take aspirin without it causing me severe stomach pain!

    I try not to take too many painkillers, because I'm well aware of the potential for medication over-use headaches. I now only take them when I really can't cope with the pain - like yesterday morning when it felt like someone was stabbing my head and it was all I could do to lift it off the pillow. I'll go back to my GP and see if any of the other triptans work for me. If not, I'll go back to the migraine centre and give them another go.

  • What's the aspirin and coke trick - do share it sounds like fun!

    Hope you get some joy soon, it can be such a miserable condition.

  • did you know that you dont have to go private as i was forsed to do,, just got leaflet from the migraine centre/ not the migraine surgery centre & on the leaflet they offer botox...did you know that...

  • I've had similar experiences with triptans, and came to the conclusion that the migraine has to burn itself out in full rather than be tampered with, otherwise it just goes on for days.

    My GP offered to try more medication after 2 triptans didn't work, but I decided not to. I have botox (for chronic pain really but it does dull the migraine headache so well worth it). I also get migraine without the headache, so although feeling sick, dizzy and weird isn't very nice it's not as debilitating as the headache, and as I can't tell from the aura what sort of migraine I'm getting it seemed pointless taking a triptan for a headache that might not happen.

    Ibuprofen with lyseine is good enough to tide me over ie I can at least drive a car and get home safely on it, then old-fashioned migraleve after that helps. Along with sleep.

    It's scary when they keep on coming.

  • ive given up on the pills although im now in agony i had to come off the concoction of pills,, they were making me so ill...so last resort for me im off to london migraine centre next saturday for botox,, for me this is last resort,, anyone else thought of this path ??

  • I have also been to migraine clinic and the suggestions have been quite helpful, I am on preventatives too, amitriptyln 40mg and pregabalin 150mg at night, when i get an attack i will take imigram 100mg if that doesn't work after an hour i take aspirin 900mg dissolved in coke, sometimes works well but very hit and miss, I am getting between 8 & 15 migraines a month, I think it must be my age, as I have had migraines for the last 30 years but they have got worse in the last year. I am also under a neuro consultant who is trying me with different preventatives but yet to find one that works effectively, although i do get a good night sleep with the ami's, not sure what effect the pregabalin is supposed to have but i will try anything as this pain is controlling my life and i need a release. Thanks to everyone who writes on this forum as it is good to know i am not alone just wish there was a cure for us.

  • just had to answer this question..ive had fibro & migraines for too long to remember,, gps had me on everything a A to Z...ater a bad experience with docs & primary care trust ( ive made a complaint ) ive taken myself off every pill,, bar 20mg of diazipam..took myself off to the migrain surgery centre in london last saturday to have botox toxin test..& today i can honestly say i feel a 70% reduction..in 3 months i go back to have the trigeminal nerve removed,, cant wait...fibro is still present but ille cope...the head pain was horrific & personaly for me i couldnt take meds any longer but ide sayto anyone try this..i feel weak but reborn & have finally got some clarity..hope this helps anyone on this site...follow me on f/book to see how i get xxx

  • How do I follow you in Facebook please

  • hello silver28 my facebook page is open & my name is janet brooksbank...ive not posted much for the last few weeks as my botox has ran its course & in agony again,, on the plus side ive a nhs app on 16th of this month for botox...i guess having to drag myself out of bed & travel all the way to london finally showed my pain specialist that..im not bonkers...& hes agreed to give me some botox...how much im not sure as yet,, but if they dont give me the right amount ille sure be raging war...ps have a look on the american headache site link on my page...but if you go back to october of last year you will see what ive had to go through...its been a nightmare...regards janet

  • Very interesting comments! In 2004/05 I attended a local Headache Clinic (Devon, UK) and was recommended to take 4 Paracetamol (2000mgs), 4 Ibuprofen (800mg) and 2 Domperidone at the first sign of a migraine. If it didn't work withing two hours take 2, 2, 1 of the above. When I bought the medication, the Pharmacist commented that she hoped I wasn't going to take the two painkillers together and nearly had a fit when I said I had been prescribed to do so! She scared me so much the most I ever dared take was a 3, 3, 2 combo, which worked quite well, but as Ibuprofen doesn't really agree with me (with or without the Domperidone) I haven't taken this for many years. I don't know if it's still recommended in such high dosages, but it may be less intrusive than medicines formulated for depression, heart problems or epilepsy all of which have caused me major problems in the past. For myself, I cope now with Zomig and paracetamol, coffee, a hot wheat and lavender pad round my neck and a rest/snooze in a reclining chair (fortunately I'm now retired) and generally I get through my 15 plus a month "bad head days" with a reasonable quality of life.

  • Correction to the above dosage details as I've just checked in my very thick "Headaches" file and it says the recommended initial dose is 3 paracetamol (1500 mgs) plus the 800 mgs of Ibuprofen and 2 domperidone.


  • Hi, been suffering from migraines on avg 3/month for over 30 years now. Have been on Imigran injections (very high dose and very expensive medicine) for over 10 years now: been very good help for me, so I definitely recommend to try them.

    In my case, I first used Imigran tablets - not helping me (threw them up), then nasal spray - not helping me, then I first had a neurospecialist check, then I was allowed the Imigran injections. 'Injection' sounds scary (I have to ly flat and look away when having blood taken), but they come in 'pens' now with a spring mechanism, so you don't have to 'push the needle' yourself; it stings and burns when the medication goes in, but it's definitely worth the relief after -minutes! Often allowed me to continue working within the hour.

    But now my doctor only gives me max 2 injections per month, so I'm left having to sit out 2 in 3 migraines and having to 'guess' when to can use the imigran, hoping I won't get a worse migraine within the month...

    This is a very strong medication and as I'm already on opoids and other medication for my Chronic Pain/ME/Fibro, I asked to see a migraine specialist, which I saw Monday. I am now trying the Zomig nasal spray (apparently much better absorbed than the Imigran nasal spray) and will see how that goes. If it helps me as well as the Imigran Injections, I'll stick to them (less strong extra chamicals into my body).

    I hope this info is useful to anyone.

    Keep smiling, A :-) :-)

  • My neurologist prescribed me tolfenamic acid which if taken at the start of an attack stops it 90% of the time. Triptons did not do me much good except making me breathless.

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