@catcat3201 you know, I am an RN, and specialist in lactation who had to give up my career because of this horrible illness of Small Fiber Neuropathy. I helped people every day in my work. I'm happy to share, and hopefully help people again!
I have not read anything about migraines, but heck, who knows! My PCP has jumped the FDA hurdles for me by being willing to prescribe it for my chronic pain when no one else would. In fact, I just used the amazing $30 coupon for a second time, and refilled my prescription. Maybe your migraine doctor will be willing to let you try it, if you promise to report back to him.
Vertex Pharmaceuticals probably won't be able to help you, because they are only approved for trials with acute pain (which they've completed) and now diabetic neuropathy (trials in progress).Not that they wouldn't WANT to help you, but their hands are tied by the FDA.
I wonder how the scientists and researchers feel about spending so many years creating this medication to treat pain, only to find that patients can't have it, either by FDA restrictions or the exorbitant price. How frustrated they must be.
I say it never hurts to ask. Tell your migraine doctor you will explore it with him, and agree to any labwork he orders to watch for untoward side effects (which most likely won't occur).
I have found that the effect is highest within the first hours of a dose. I took at at 8 am today. I had a steroid injection in my hand at 2 pm, and the magic wasn't as strong as the hand injections in September, when I had morning appointments. So I know now to take it just a few hours before I really need the best relief. I can definitely feel it wearing off before the 12 hour mark. A higher dose more often would be ideal . We'll get there someday!