DEAR DR. DONOHUE: For the past year, I have had bad headaches that my doctor says are migraines. I take Imitrex for them. It takes the pain away a little, but these headaches still lay me up. I’ve been told migraines are on one side of the head; my head hurts all over. I never see any flashing lights before the headache. I do have to go to a quiet place and lie down until they’re over. Could my headaches not be migraines? – R.C.

ANSWER: Migraine headaches haven’t read their script. They often don’t follow a stereotypical course. Often, they’re one-sided headaches – but not always. Children’s migraines are more frequently on both sides than on one side, and quite a few adults have the same kind of migraines. The flashing lights you speak of are called an aura. Auras happen, at most, to 20 percent of migraine sufferers. Migraines often make people sick to their stomach. They compel patients to seek a quiet, dark place to lie down, as sound and light exacerbate the headaches. Any activity makes them worse. Your symptoms sound to me like a migraine, even though there are some variations from the commonly described migraine symptoms.

Your medicine, Imitrex, is a triptan medicine. Those medicines are the biggest breakthrough in migraine treatment in our lifetime. There are seven of them. Perhaps a change to another one might give you greater relief. Or an increase in the dose you’re taking could be all you need. A combination of medicines is another way to obtain migraine relief, and a triptan coupled with an NSAID like Aleve makes a powerful pair. Many times, a migraine delays stomach-emptying, so oral medicines might not get to work fast and might not be absorbed well. Your medicine and the triptan Zomig come in nasal sprays, which might work more effectively for you.

An older medicine, ergotamine, still works well and could be tried as a substitute.

The headache booklet gives the facts on all the headache varieties and their treatments. Readers can obtain a copy by writing: Dr. Donohue – No. 901, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Is douching good for feminine hygiene? I wonder if it’s necessary and if it prevents vaginal infections. – A.L.

ANSWER: Douching is a purported way of cleansing the vagina with a stream of water (to which women add many other substances, like liquid soaps) that comes from a container through a thin rubber hose. It’s not necessary, and it doesn’t prevent infections. It should be done only if a doctor instructs a woman to douche.

DEAR DR. DONOHUE: My grandson used to be into drugs. His mother, my daughter, says he has turned his life around and is no longer taking them. She also mentioned to me that his therapist has put the young man on Depakote. His father thinks this is a dangerous drug that will affect his mind. My daughter has been in a battle with her husband to keep the boy on medicine. What are your thoughts? – J.B.

ANSWER: I forget the name of the man who devised the following medical rules, but they’re worth mentioning even if I can’t provide the author’s name. They are: “If something works, keep doing it. If something doesn’t work, stop doing it. If you don’t know what to do, don’t do anything.” Depakote is working. Don’t stop it.

Depakote has been used for many years as a seizure-control medicine. It is also used for bipolar disorder, and I believe that’s why it was prescribed for your grandson. It doesn’t affect the mind. It won’t turn him into a zombie. It will aid in the correction of any imbalance in brain chemistry that makes him have mood swings.

Depakote, on rare occasions, has caused liver or pancreas damage. If it does, the medicine is stopped.

Your son-in-law should not intrude on a successful medicine program. He has more to fear from illegal drugs affecting his son’s mind than he does from Depakote doing so.

DEAR DR. DONOHUE: A national magazine wrote about alpha-lipoic acid and carnitine as being helpful for our aging bodies. Please let me know your opinion on these supplements and if they are safe to use with other medicines. – F.W.

ANSWER: Alpha-lipoic acid is an antioxidant. Antioxidants protect cells and tissues from the oxidizing effect of chemical byproducts resulting from the body’s metabolism. Oxidizing is the equivalent of rusting. Alpha-lipoic acid is also involved in energy production within cells. The cells’ power stations are called mitochondria, and it’s there that alpha-lipoic acid’s effects take place. Its third function is to protect DNA, the stuff that directs what cells do and furnishes information for the production of proteins. Claims have been made that it prevents heart disease, stroke, diabetes and cataracts.

Carnitine is an amino acid, the basic unit of all proteins. In addition, carnitine acts a teamster, delivering fat to mitochondria for generating energy. Carnitine is said to promote weight loss, increase energy and slow the aging process.

In laboratory animals, the combination of alpha-lipoic acid and carnitine seems to have a rejuvenating effect. Whether these two substances have the same effect in humans remains to be proved.

I believe they are safe even when taken with other medicines. I don’t know if they do all they’re said to do. I am waiting for the results of more trials until I get in line to buy them, singly or in combination.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com