I was diagnosed about two years ago and have been on Topamax with Imitrex as a back up. I was always an episodic sufferer getting my visits from the beast at night. Now that I am experiencing my first cycle, I am getting breaktroughs of Kip 1-2 during the day, but they seem to last longer than normal. With the new insurance company only covering two boxes of Imitrex a month (got the docs office working to change that), I have to ration what I have.

In order to offer any real help, I think that this group needs to hear a lot more about your headaches. Simple information can go a long way to help others help you.

Things like, how often do they occur?
What triggers them for you?
How long do they last?
How well do abortive meds work for you?
What do you do to help the pain?
What kind of headache history do you have?

Growing up, I had sinus headaches off and on my whole life. I also suffered from car sickness until I reached eight or nine; I'd have to sit by the window on long drives or I'd have to have my mom stop the car so I could get out and throw up. Always lived in the midwest. Went through menopause two years ago. The CH started about ten to twelve years ago. They were few and far between, but they were probably Kip 7 - 8. They always hit at night and I can't recall a specific trigger that set them off. My doc finally sent me to a neuro and I got diagnosed and was put on Topamax with Imitrex shots for a backup. I've been on this combination for about two years now and it has always seemed to hold the beast at bay. Any breakthrough headaches came at night and were much less severe than before I was diagnosed. Last month something changed; my diet stayed the same, but I seem to have become a cycle sufferer. I'm into the third (or is it fourth) week of this cycle, but I can't complain too much. The CH hits during the day starting before noon and I'm getting one to three of these low grade (Kip 1 - 2) headaches a day now lasting an hour or so. It switches side to side to add variety to my life. Dealing with the pain is a matter of remembering it will go away; I have my shots with me if it gets to the point that I can't handle it. Otherwise I tough it out; I know there are guys in much worse shape than me on this group and I don't want to seem like a whiner. If I can feel it coming soon enough, I chug a Loca Moca which seems to help as an abortive, too. I had my hormones checked and they are normal for my stage of life. I'm gonna try a light therapy light to see if I can readjust the melatonin and seratonin levels to see if that helps. We took the TV out of the bedroom to further the melatonin readjustment. My new insurance co will only pay for two boxes of imitrex a month, but the PA and nurse are addressing that issue. I got a scrip for Treximet as an emergency backup from the PA; the insurance co considers it non-preferred so it would cost me $35 for 9 pills. She also gave me a coupon for $25; I could live with $1 per pill, but $4 per pill is just wrong.
Sorry to have rambled on. Hopefully this info will help you help me.