What to Do When Migraine Medications Don't Help

Migraines can be debilitating, impacting every aspect of daily life. Unfortunately, for those who suffer from them, finding the right treatment can sometimes be as frustrating as the migraine.

Neurologist Dr. Wade Steeves at Valley Neurology in Spokane Valley is happy about being known as Washington’s “Headache Guy.” He works diligently to provide effective solutions for headaches of all types, including treatment-resistant migraines.

Working with a specialist gives you many options for effective migraine treatment. Read more about the treatments Dr. Steeves may consider when migraines aren’t responding to your current regimen.

Understanding migraines

Migraines are a neurological condition characterized by severe, throbbing headaches often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound. They can last hours or days, making it difficult for sufferers to carry out daily activities.

Because of the neurological connection, it makes sense to consult a specialist when migraines aren’t responding to traditional headache remedies.

Understanding the neurological connection

Neurologically, migraines are thought to involve abnormal brain activity, particularly in the trigeminal nerve, responsible for sensation in the face and motor functions such as biting and chewing.

Various neurotransmitters released during a migraine attack, including serotonin and calcitonin gene-related peptide (CGRP), can cause inflammation and dilation of blood vessels in the brain.

Additionally, certain brain areas involved in pain processing and regulation, such as the hypothalamus and brainstem, may be dysfunctional during a migraine. Changes in blood flow and electrical activity in the brain have also been observed.

Overall, the neurological involvement of migraines is complex and multifaceted, involving various pathways and mechanisms within the brain. Considering all these factors is crucial when designing effective, comprehensive migraine treatment.

If your current medication isn’t helping, it’s possible you need a different medicine or a boost from other migraine therapies.

Treating and preventing migraines

Dr. Steeves offers advanced diagnostics and treatment options tailored to your specific needs.

Your experience at Valley Neurology begins with a thorough evaluation that includes a detailed discussion of your migraine history, treatments you’ve tried, and other essential factors.

Your individualized plan may include:

Identifying triggers and adopting healthy habits

Understanding triggers is essential in managing migraines. They can vary from person to person, but common migraine triggers include stress, certain foods, hormonal changes, lack of sleep, and environmental factors like bright lights or strong odors.

Our Valley Neurology team can help you identify headache patterns and potential triggers. Start by keeping a migraine diary that briefly details your migraine experience. That may seem overly simple, but it’s one of the critical components of effective migraine treatment.

Lifestyle adjustments — such as maintaining a regular sleep schedule, staying hydrated, managing stress, avoiding known trigger foods, and incorporating regular exercise into your routine — can help reduce migraine frequency and severity.

Newly developed medications

In recent years, regulatory agencies such as the FDA have approved several new medications specifically designed for migraine prevention and treatment. These medications target pathways in the brain involved in migraine development, offering new avenues for relief:

• CGRP inhibitors reduce migraine frequency and severity
• Ditans, such as Reyvow® (lasmiditan), treat acute migraine attacks
• Gepants provide rapid pain relief for acute migraines
• Anti-seizure medications stabilize electrical brain activity and prevent migraines

Botox® injections also can prevent chronic migraines in adults by blocking the release of certain neurotransmitters involved in pain signaling. 

Dr. Steeves could also consider a nerve block as part of your migraine treatment plan, which prevents nerves from transmitting pain signals.

Schedule an evaluation with Dr. Steeves at Valley Neurology for customized migraine care. Call the office or request an appointment online.