My brother has frequent migraines and has tried a few different medications for them, topomax/toprimate, another pill, a nasal spray called Amvig (or amivag, don’t remember lol), and finally Botox shots. He’s had the most success with Botox shots. He went from so many migraines he had to take medical leave from work for 6 months, to like one migraine every few months with the Botox shots.
Worth noting that sometimes doctors will use anticonvulsants (such as toprimate) to treat migraines, and many anticonvulsants do make hormonal birth control ineffective.
Starting to see a neurologist rather than his GP for his migraines really helped my brother because the neurologist was able to push for insurance to cover the Botox injections. Another thing he did was log his migraines (date, length of migraine, severity) and bring those to appointments with his GP and his neurologist.
