Some patients will need the stronger narcotics or barbiturates, especially for severe attacks, Lipton acknowledges. But, "the reality is they're overused" in migraines, he says, advising that patients who truly need them limit weekly doses.
Chronic migraine aside, getting out of the medication-overuse rut is hard. In New Jersey, it took Cerbone several tries before she found a migraine specialist who cut her prescription painkiller cold turkey and found a daily prevention medication that has worked since August.
Headache specialists advise:
-Ask about migraine-prevention drugs. Choices range from blood pressure-lowering drugs called beta-blockers to epilepsy drugs and certain antidepressants, all of which have side effects to be considered. Some patients even try Botox injections, to quiet overactive nerve endings.
-Quit the overused medication, but brace for painful withdrawal. A doctor may advise different short-term medications to help.
-Use a headache diary to pinpoint migraine triggers and learn to minimize them.




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