The nightmares you guys describe makes my headaches seem like small fry. When I went to see my GP to say that I kept getting headaches in my left temple and asked what the matter might be, he said very scornfully, 'Do you think you've got a brain tumour then?' I told him that it was his job to find out. I had a scan that turned up nothing but did get triptans prescribed. No one called it migraine because all I ever got (get) is raging pain in the left temple and down the side of my face. When I discovered the existence of trigeminal neuralgia and the fact that the central branch of the trigeminal nerve runs down the track of my pain, the conclusion seemed obvious. Neurologist said 'No!' It didn't quite behave right so he said 'Let's call it migraine, but what's in a name? The treatment's the same: it's Lamotrigine.
I take Lamotrigine as a mood stabiliser, it is prescribed off licence for bipolar but is actually an anti-epileptic, it is also used to treat migraine. I had never heard of such before that neurologist told me, and I have never heard a migraine sufferer or other doctor suggest it. I was only on 200mg a day, which used to be all they would give as a mood stabiliser because it is off licence, but the neurologist said that some of his patients were on up to 600mg a day as it is a very well tolerated drug. It has very few side effects, except a risk of a serious and dangerous rash that will manifest in the early stages of taking it but can mostly be avoided if you titrate it very slowly: very, very slowly! When I told the psychiatrist what the neurologist had said about the dose I think they got talking to each other because now the restriction doesn't seem to be there. Oddly, when I was on the lower dose, the headaches had got much more frequent and severe. I'd had them all my life: I remember sitting in class in school with my fingers gripping my temples and my little fingers in the corners of my eyes, because the pressure seemed to help a bit, but no one took any notice in those days. Maybe they thought kids didn't get migraines. Anyway, when I upped the Lamotrigine dose to 300mg a day, the headaches almost completely stopped. The only time I get them now is if I have a prolonged, not too severe hypo. Say between 3 and 4 for a few hours without realising; or a succession of hypos will trigger one.
I think the correct diagnosis is probably trigeminal neuralgia despite the lack of classical shooting pain symptoms - mine is continuous - after all, it's in the trigeminal nerve and it hurts and that is what the term means. Nerve pain. No brainer. But they call it migraine.
I waffle too much. My point is that Lamotrigine is used to treat migraine, or to prevent it. I don't think you can take lamotrigine as a one off dose, but have to take it long term as a preventative, but don't quote me on that, it's more of a guess than certain knowledge. Ask your neurologists about it and see what they say. I barely get my headaches any more and they stopped at the time my lamotrigine dose went up, so I'd be very surprised if that is not what did the trick. If I do get them I take almotriptan and that works, but I hate the side effects: jelly legs. Vasoconstritors seem to constrict the blood vessels everywhere as well as in the head where the pressure that's causing the pain is.
Good luck folks.