Q. I have been on Fioricet for 2 years. I had been taking 6 tablets a day. My physician recommended that I cut back, due to rebound headache, every 4 days. I have now cut back to 3 tablets, and I’m experiencing extreme drowsiness and agitation.  I was told it’s not a side effect. Do you have any recommendations for alternative medication(s) that I can try? Also, I would like to know if you’ve ever heard of anyone else experiencing these types of side effects.

[caption id="attachment_2735" align="aligncenter" width="600"] A recent study indicates that aspirin taken with acetaminophen and caffeine is more effective than aspirin alone.[/caption] Tension headaches are the most common form of headaches and affect more than 20% of the population. Frequently, tension headache sufferers turn to over-the-counter medications for relief. A recent study indicates that medication containing a combination of acetylsalicylic acid, (aspirin), acetaminophen, and caffeine is more effective than acetaminophen alone.

Several medications were recently deemed the most effective for treating acute migraine, including triptans, dihydroergotamine (DHE), nonsteroidal anti-inflammatory drugs (NSAIDS), butorphanol nasal spray, and the combination medication of sumatriptan/naproxen and acetaminophen/aspirin/caffein). Several other migraine medications were considered "probably effective" or "possibly effective."

Q. I have had a kidney removed due to cancer. Consequently, I've been told to avoid nonsteroidal anti-inflammatories (NSAIDs) and other pain relievers that are metabolized through the kidneys so as to not stress the remaining kidney. Acetaminophen no longer provides any relief for my migraines. The triptans work, but always result in a bad rebound headache about 20 hours later. Are there any acute medications for migraine, other than the triptans, that are not metabolized through the kidneys? I have 9 to 11 days a month of migraine and have not found a preventive medication that works.