Q: My wife’s doctor has tried about 5 medicines to control her migraine headaches. None have worked, and she said there isn’t an effective alternative therapy.

She gave her a script for Midrin, which is discontinued. Is there a better/safer alternative? Her migraines are severely debilitating, and the preventatives haven’t worked. She teaches special ed at a year-round school and is taking night classes, so when she gets a migraine it severely disrupts her life.

A: Migraines are complex situations – often started by a trigger, and commonly associated with hormone imbalance. I’m particularly sensitive to MSG. Even small amounts can trigger a headache. However, I am very careful about what I eat, so when I actually come in contact with MSG, the attack is light.

Yes, Midrin was discontinued, but we have a replacement formula. It doesn’t contain exactly the same ingredients, but it is darn close. Other compounders are making it and people are happy with it. It’s like other migrain pain relievers. It doesn’t do anything to prevent the headache, only treat it once it starts. That’s common, but I think it is irrational, especially when it is possible to discover the causes/triggers. It isn’t easy. It takes time.

The end results are excellent and long lasting – unlike drug treatment for pain. From this perspective, I do not think Midrin (or its replacement) is a reasonable, long term solution. To make matter worse, the formula contains a sedative and there are severe warnings about driving “while under the influence” of the medication. It can be difficult to function while taking the drug. The pain might go away, but the effects of the sedative linger. Some people also report hangover type headaches the day after using the drug. They aren’t as bad as the migraine, but they are still painful.

I would think it best to search for triggers. Many are in food. A good approach is to search labels on products and make sure there isn’t MSG (or similar products). There are some pages on our website that discuss the problems. .. see these links for more information

MSG In Food @ TheCompounder.com    

MSG & Gelatin @ TheCompounder.com     

Hidden Sources of MSG @ TheCompounder.com

Aspartame (artificial sweeteners in general) are also notorious for triggering migraines. Here’s a link about doing an elimination diet on wikipedia: http://bit.ly/gbSgzm

The Midrin replacement may be useful while searching. Your local compounder can make it for you.