Drifting off-topic, but have you tried sumatriptan ("Imitrex")? It seems to have a near-total effectiveness on my ~monthly migraines. Neither acetaminophen nor NSAIDs ever did anything for my migraines.

I agree that directly addressing underlying causes like stress, noise, sleep, and diet are better than a pill.

I was about to say the same thing - sumatriptan works amazingly well for my migraines. I'm in the UK though, and I seem to recall someone on HN saying it was very expensive in the US.

It might have once been expensive ("Imitrex" (R)(TM)) but there is a generic now. I understand there are also non-pill delivery systems, like nasal or patches, and other permutations that may still be under patent. The pills seem to work for me.

Triptans work for me as well, but they’re too hard on my body. It’s aftually pretty scary how they work.

Can I ask what side effects it is you get? Just curious since there don't appear to be any negative effects at all for me.

It works by causing your muscles tissues to dialate or something like that. My doctor explained taking too many in too short a time could cause a stroke or heart attack, forget which exactly. One side effect i get is my skin becoming highly sensitive to heat. We’re talking luke warm shower water feeling something like scalding hot. It’s not that exactly either, very weird sensation. Other times my throats tensed up similar to when you eat something highly sour.