Can migraine attacks be prevented?

Patient

Q: I'm 16, and I get between 3-4 migraines a week that last from 4-12 hours usually. When I get my migraine; I lose my balance, when i move my vision goes into a foggy black blindness (sometimes I lose all vision for 5 minutes at a time or so), I get sharp pains in my right ear, I sweat and feel hot even though my body temperature drops, I hear high pitched ringing noises every once and a while, I also hear cell phone tones that aren't there, it feels like something is squishing my brain every time I move my eyes or head. I don't smoke, I don't drink, I eat healthy and I sleep 8-10 hours a night. I have gone to the hospital before where they gave me a CT scan and found nothing, they prescribed me some pills for nausea that were suppose to help with my migraine but had no effect. I've tried codeine, Tylenol, Advil, a cold towel on my forehead, antidepressants (I'm not depressed, I read it helped on another website). Nothing has worked. What can I do?

Doctor

A:   You should see your doctor and ask for medications to prevent migraine attacks. Some medications used to treat migraines may not be very effective once the attack has started already. In your case, I think it is reasonable to have preventive medications because you have >3 migraine attacks per month that are not responsive to medications. Amitriptylline and Nortriptylline are antidepressants that also help prevent migraine. I would not agree you taking this without a doctor’s advice because you may have the wrong dose. It is noteworthy that most of the medications to prevent migraine may not have immediate effects; it may take 2-6 weeks before significant effects are observed. You will also need to take them everyday. I do hope this helps.

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