Hello doctor, I am 32 years old. I have been suffering from a migraine for over five to six years or more. I have been sensitive to light since childhood. I used to take Migranil initially. Around two years ago, I met a neurologist and he advised me Amitone at night and Naxdom 500 in case of emergency (at the onset of a headache). It had given me a substantial relief but then I had to take Naxdom almost every other day. I have been trying to taper off but have been unsuccessful. I still have to take Naxdom 500 every three days (on average) else I just cannot carry on with my day. I do not take Amitone anymore as it had started making me extremely sleepy in the morning and working hours as well. When I have a migraine:  I suffer from a throbbing pain usually emerging from the left side of the head and it keeps spreading. The pain grows into nausea and vomiting sensations. High intolerance to light (sunlight feels impossible to tolerate), sound, any distinct smell, non-cotton clothes. I am not able to handle even minor stress somehow which definitely does not feel normal. Naxdom is the only medicine that helps in such a case but how long can I keep depending on such painkillers? I had suddenly gained weight and had developed hypothyroidism in between. Can these medications be a culprit?  Also, I want to know all the possible side-effects of Naxdom and Amitone, please. Kindly note, I have hypothyroidism as well. I have recently gone through a miscarriage and will be trying for pregnancy soon in approximately three to four months. But, at least for a month or so I want to get rid of my migraine issues. When I was pregnant, my doctor had said if it feels absolutely necessary I can take Naxdom at times. I had it only twice though during my pregnancy. What is the prescribed dosage of Naxdom during pregnancy in such an inevitable case? Also, please note even without a migraine attack, am generally very very prone to nausea and exhaustion since years (when it is hot, when I am stressed, long working hours or just for no plausible reason). What safe medications can I take to get rid of these nauseous feeling and vomiting tendencies and any tests I should get done? All these factors have been affecting the quality of life adversely and I do not feel these are normal symptoms as I have tried multiple solutions so far.
Hi. Your symptoms are classically suggestive of a migraine only. Now, migraine can be well controlled with medicines and lifestyle changes. My choice remains Amitone (Amitryptiline) along with Flunarizine. Side effect profile of Amitone contains mostly sedation and weight gain. Otherwise, it is safe to take. Naxdom is a painkiller and should be taken in only severe headaches. Now, point is that you want to conceive now, so in pregnancy, we usually advise our patients to take Paracetamol for headaches. A lot of people get their migraine resolved during the pregnancy period. However, in cases where we need to give medicines, the recommended drug is Propanolol, which is relatively safe in pregnancy. So, if you wish to start treatment, then discuss with your doctor to start you on Propanolol. This drug can be continued even if you conceive.  For more information consult a criticalcare physician online -->