I don't actually have this problem. I do have a problem with triptans in general. Side effects of breathing problems and chest pains that occur to some degree with all of them. I sort of forget sometimes how bad one has been until I look it up and then... yep, it was bad with that one too but in a more breathing way rather than a chest pain way or vice verca, or balanced between the two. Any way when I don't have a rescue med which happens depending on whichever neuro I happen to be seeing at the time or the rescue med is something like T3s which really are not that effective then obviously I use more triptans despite the side effects... even though usually the maximum I am comfortable using is three times a week which would be roughly 9 a month. However neuros say you can use them three Days a week, not three times a week, which means if your triptan says you can take four times a day you can take obviously Way more times a month. By the way this is according to my most recent neuro so listen to yours not mine. So when I am having troubles with pain management I obviously don't listen to that because the side effects would cause some serious issues but I do use more often and maybe sometimes twice a day instead. I did have the insurance company have issue with the amount I was taking saying it was 'unsafe' and that was I believe less than 9 even. I just needed a letter from my doctor saying that was the way it was... according to my neuro I could go nuts on the things if I wanted to. For me, I'm very careful though and hesitate to take them more than once a day or two days in a row because of those side effects. Although it wouldn't be a problem... if I chose not to.
Nevertheless we still 'ration' them. Because we can only take them three days out of the week and that means choosing which migraines to treat and which ones not to treat. And choosing really, really fast. For me since I cannot treat two days in a row I treat one day and the next day can be horrific but I'm out of luck. Not anyone's fault. Just the way chronic migraines are. If I have no alternative treatment then that really sucks for me and that is my neuros fault.
One thing my insurance company did do that pissed me off was send out this form to get my doctor to fill out that said basically they would not cover triptans unless my doctor had already looked at treating my migraines with OTC meds like Tylenol and anti-inflamatories and also ergotomines. First of all that pissed me off because they are interfering with how a doctor is treating a patient. Now this has nothing to do with me because obviously having migraines as long as I have and chronic ones at that I've been treated with many things but for a brand spanking new migraine patient who has episodic migraines they should be treated with triptans which are the most effective treatment out there and should not be overusing OTC meds which could be causing side effects and rebound headaches... but most importantly are not aborting the migraine. And ergotomines will work but they are old school and cause a lot more nausea. And so now a new patient has to I suppose demonstrate that OTC stuff doesn't work or overused them to the point they made the situation worse or wrecked their stomach on them, or wrecked their stomach on other anti-inflamtories prescribed by the doctor that were also on the list. Or get ergotomines which I have been on and they do work... but better give them something for the nausea while your at it. I don't think they have the right to take a doctors choice like that when there are so many excellent triptans that would help people out. After I got my form signed... they ended up charging me 5bucks each time... maybe because I go over the recommended amount they consider 'safe'?