ANy advice for a friend who has hit a wall with migraine relief?

[DeadLetterOffice]

2. I finally caved and started Botox injections

They're only appropriate if you're a "chronic migraineur" -- 15 or more migraine days a month -- but for many of us they make a huge difference. I'm on several prevention meds, plus I have Frovatriptan for when the migraine is really bad, but it was starting Botox 2 years ago that made the difference between completely incapacitated all the damn time and getting to have a semblance of a life. It's not an instant fix - it can take several treatments (12 weeks apart) to work, and it doesn't work for everyone.

If your friend meets the "chronic" criteria, I'd strongly suggest that they talk to their neurologist about Botox.