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Comment by RobertRoberts | Hacker News Reader

I wonder if there are multiple different causes. Because I have had migraines regularly since I was a little kid and sleep was the only cure. (Hours of crying until I'd pass out) But when I got to a teen I tried every pain killer I could find and finally I found that none of them helped unless I took it very early when the pain started. (Within maybe 30-40 min) And even then only ibuprofen worked. (And I have to take quite a bit) But even then the pain doesn't go away for some time. But at least it doesn't get any worse.

So I keep ibuprofen in every car, bag, and a few places around the house.

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OTC medication is not typically strong enough to fully fend off a migraine (no, excedrin migraine doesn’t count). Go see a doctor, explain your symptoms etc and get prescribed something like rizatriptan.

Seconding Rizatriptan. It's a game changer. It also seems to work better earlier, before the pounding really sets in, but in the worst case it still turns it down a lot.

In addition to triptans, there's another class of migraine medication that's relatively new, but given the cost and back and forth your doctor will have to do, they prefer to start with triptans: *gepant drugs like Nurtec and Ubrelvy.

Just wanted to third this recommendation, as it does defeat some of my migraines. I had brain surgery, get em every week. Rizatriptan is a life saver.

Did you have any side effects from rizatriptan?

Not really!

Emphasis on the "something like": there are several different drugs in this class (triptans), and it might take a couple of tries to get one that works for you.

Personally, sumatriptan doesn't work reliably, rizatriptan makes me feel super woozy, but eletriptan works well and without noticeable side effects.

Hence seeing a doctor to get a prescription and follow up :)

We tried with diclofenac first, didn’t work at all.

For all of the other folks here saying ibuprofen isn't strong enough: I have the same, and only with ibuprofen (vs. other over-the-counter drugs like aspirin or paracetemol): if I catch it early enough, sometimes it staves off the full blown migraine development.

I've had migraines since childhood, fortunately only every couple months for 2-4 hours. Weirdly, I'm so used to the pain at this point that I kind of take it in stride.

The downside is that ibuprofen also often upsets my stomach, and in the bad ones, I barf from the pain, so there's a gamble as to which route to go down.

This is similar to my symptoms. So far I haven't found any over the counter painkiller that helps me reliably. At least not in the doses you're supposed to take.

A few years ago I read something about a theory that migraines have to do with the body's heat regulation, and it was suggested to try a hot shower. That does seem to help me. So nowadays when I get a migraine (thankfully only about five times per year or so) I run a hot bath and stay in the tub for two to three hours. It's not fun, and for the first few minutes the headache gets worse and really starts pounding (blood pressure changes due to the heat maybe? I don't know). But then the heat does seem to take a lot of the edge off, and after a while the pain actually stops. Which it doesn't reliably do with painkillers only. Much better than lying around in bed, unable to sleep.

Not medical advice, your mileage will vary. But might be something others would want to try. If you're going to suffer and wait for it to stop, you might as well consider doing that in the bath.

Same experience (sleep helped as a kid but now not anymore).

A neurologist prescribed me Metagelan.

I asked this about the other recommended drug above to...

Any side effects you got from Metagelan?

Any idea how/why it works for you?

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