Q. I have been reading NHF’s HeadWise for a few years now and find it very informative and helpful. I wish I didn’t need the information, but I have been diagnosed with cluster migraines. True to pattern, I can go two to three years without migraines except for two to three migraines per month occurring prior to my period. The clusters occur two to three times a day for a few months then remit for a couple of years. After every cluster, I always hope it will be my last time. Are they ever going to stop? Does a person outgrow them? I am currently taking amitriptyline daily, Imitrex® as needed and have just started Topamax® as a preventive when a cycle strikes.

Q. I have been on Depakote® and amitriptyline for migraines since about 1996. I kept the headaches reasonably under control (I've had them since 1985) with those two preventive medications and lifestyle management (strict diet, regular exercise, enough sleep and decreasing stress). I do, however, have moderately severe arthritis of the neck from a car accident in the 1970s. For the past year, I have had a migraine every day except four intermittent days; I can't figure out what I could be doing wrong. I avoid rebound headaches by alternating my use of Norgesic Forte® with Tylenol 500®, or when necessary, Imitrex® or Amerge®. I'm careful not to take more than the prescribed amount of any medication. My question is this: Would Neurontin® be of help to me? Has Depakote ceased to be effective? Or could the arthritis in my neck have finally won the battle I've been having with it? My neck pain is excruciating at the end of a work day, especially if I've had a headache. Neck pain is one of the precursors to a migraine for me.

I am 62-years old and have had chronic migraine since at least 7-years old, although they could have begun before that time. 62 years ago no one paid attention to a child with headaches except to give me aspirin, Excedrin, etc. I lived on these pills for most of my childhood, adolescent, & early adult life, and likely adding to the headache problem, which changed the migraine to transformed, and then to rebound headaches. On a scale of 1-10, I would describe them as 100. A good week would be only two migraines, but many times, there are many more. I learned to tough it out, and somehow managed getting through high school, getting married, and having three children.

Since I was a child I remember getting "sick headaches." We would go out and play baseball on a sunny Saturday morning and then I would spend that afternoon and night in my room with a cold rag on my head silently suffering. My mother had headaches all of her life with terrible nausea, but thankfully, I never had the nausea. As I grew into young adulthood, I realized the patterns and triggers in my headaches so I was able to control them to a degree. They were manageable, but never gone.

I get migraines about twice a week, especially when there is a change in the weather. I usually wake up with it. So of course my head is throbbing, and the need to vomit forces me to get up. Once I am up, I cannot lay back down, because by head feels like it is going to explode if I lay it down on the pillow. So I usually just stay in the bathroom with a pillow against the wall. The doctor has given medication to take to stop the nausea, once that is gone, I will take an Imitrex. It usually requires me to take another one two hours later, and before the heads subsides a little, but it really does not totally go away.

Q. I have had migraines for over 20 years. For many years now I have been on a beta-blocker for preventive therapy as I failed to tolerate Imitrex® or Topamax®. My headaches usually begin after excessive stress and fatigue, but can occur anytime. In spite of having a very healthy lifestyle, I still have migraines at least twice a month, which unfailingly last three days. Do you have any other ideas for me?