How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Thomas, MD Your Own Question

Dr. Thomas, MD
Dr. Thomas, MD, Board Certified MD
Category: Medical
Satisfied Customers: 63757
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
24257177
Type Your Medical Question Here...
Dr. Thomas, MD is online now

There I get severe migraine which lasts two weeks

Customer Question

Hi there I get severe migraine which lasts for around two weeks and was having them every month. I am having Botox which has slowed it down to once every two months but unfortunately I had them in quick succession so my migraine lasts a month. I'm on 125mg dosulepin. I've had flunarazine sumitriptan but I'm still having them. Any advice would be welcome. Thank you
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Phil, MD replied 1 year ago.
I would try topamax daily as a preventative.It works very wellStart at 50 mg and increase by 25 mg per week until controlled
Expert:  Dr. Thomas, MD replied 1 year ago.
HelloI have a different answer for you.In fact, dosulepin is a tri cyclic anti-depressant.It would have major and potentially very dangerous interactions with topamax.Selection of a preventative medication must be individualized.For example, there are newer antidepressant type medications that prevent migraine [effexor, as opposed to most SSRIs which have not been so helpful].A beta blocker is more indicated in some people.Sometimes a calcium channel blocker.Sometimes a drug like topamax.Here is a mayo clinic rundown on these drugs:http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/treatment/con-20026358 This must be based on the selection by a migraine expert, who knows your entire history and the nature of your migraines.Treatment is not one size fits all.There are also preventative measures:See this mayo page:http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/prevention/con-20026358In addition, studies have indicated a magnesium deficiency problem in those with migraines. 50% of patients will respond to magnesium replacement. In those who have mitral valve prolapse, 90%. Nutritional considerations are therefore also important. Including diet, avoiding foods that trigger the migraine. IN alternative medicine, acupuncture has helped a lot of migraine patients acutely.Biofeedback has also been shown to be effective in clinical trials. OK, so that is an initial answer….Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
Expert:  Dr. Phil, MD replied 1 year ago.
Yes, I was suggesting that you use topamax instead of your current medication
This would obviously need to be discussed with your doctor
A CAT scan or MRI might be needed to rule out other issues given that your headaches have changed
Expert:  Dr. Thomas, MD replied 1 year ago.
HelloThis is the expert who gave you the extensive answer above.Topamax is an anti-seizure medication that can help with migraines.It is one of many.I see no indication for an MRI, as you have no exam findings you state that indicate this need. That is something to discuss with your doctor.That would not simply be done because you have a few more migraines.See also these lifestyle interventions.http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/lifestyle-home-remedies/con-20026358 Find me in medical any day, by request.Please click a positive rating on my answer page [see the top] if you appreciate my extensive answer above, and my follow up.I would be glad to go more into integrative medicine on another post.Good luck.dt

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
< Previous | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
 
 
 

Meet The Experts:

 
 
 
  • Family Physician

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
< Last | Next >
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
  • http://ww2.justanswer.com/uploads/DO/DoctorRich/2012-9-12_72454_Doctorweb.64x64.jpg Dr. Natasha's Avatar

    Dr. Natasha

    Doctor

    Satisfied Customers:

    7887
    American Board Certified in Emergency Medicine, Ivy League trained
  • http://ww2.justanswer.com/uploads/DR/DrK99/newpic2.64x64.jpg Dr. K.'s Avatar

    Dr. K.

    Board Certified MD

    Satisfied Customers:

    255
    Board certified with experience in primary care.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjtu60wne/2011-2-14_183449_passportphoto2.64x64.jpg docwithheart's Avatar

    docwithheart

    Board Certified Physician

    Satisfied Customers:

    0
    Board certified pediatrician, with special experience in general pediatrics, hospital pediatrics, and pediatric cardiology
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Board Certified Physician

    Satisfied Customers:

    12373
    20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
 
 
 

Related Medical Questions