To : Cindy
Re : Migraines

Migraine treatment largely depends on the frequency and severity of attach.
If it happens once a month or every 2-3 weeks, then the acute treatment with
Imitrex,  Fiorinal, Codeine, Demerol or morphine is probably all right.  We
are only concerned about Demerol when the doses are cumulative over several
days.

If on the other hand, the migraines are persistent, or occur often, such as
every few days or once weekly,  then prophylactic therapy with propranolol,
metoprolol, or amitriptyline  is suggested.  A newer treatment with
gabapentin (Neurontin) is apparently effective as well and may have fewer
sedative side effects.  Although we have no data on Neurontin in
breastfeeding patients, it is becoming quite popular in convulsive patients
due to its lack of major sedation.

But migraine treatment is highly variably, and each patient is apparently
different, and responds differently to drugs.  So its a big toss up as which
medication is going to work, unfortunately.



Regards

Tom Hale, R.Ph., Ph.D.
Associate Professor of Pediatrics

http://neonatal.ttuhsc.edu/lact/