Topiramate is suggested as the next to try . . . . . . . .then Almotriptan
So sorry if it seems that I'm making already bad news even worse, but
my gut feeling is that neither of these two will be welcomed with open arms at the good old Belgrano !
Triptans as a group are 5-HT antagonists, which probably work quite well in many cases of migraine, but, as with so many things, have the potential for some degree of drowsiness or impairment of alertness, at the very least.
Topiramate is probably even worse, as its principal indication is as an anticonvulsant in major epilepsy. Its use as migraine prophylaxis is a secondary one, and not extensively trialled or tested. As you can probably imagine, even the mention of the word "
epilepsy" within the hallowed portals of the Belgrano is likely to trigger what is little short of a tsunami !
Please explain what you mean by " A and C spanner tickets" ! !