I too am sorry to read that you suffer from headaches. I've had the "buggers" for years! Fortunately, they have improved for me (with great effort), but they still haunt me.
I take a medication in the same family...its called Desipramine. I had heard that the side effects are ever so slightly less than Elavil. I only take 25 mgs. My doctor wanted me to take 50 mgs...but it made me tooo sleepy. I've taken the higher dosage periodically, but only do so when absolutely necessary and for brief periods of time. A little side note...I've taken it (the higher dosage) when suffering from depression. It's a "two for one" for me! LOL!
Since, it's really an AD. However, again, I don't like the SE and for me, that kinda backfires. So, I sort of weigh one thing against the other.
This is going to sound really, really weird...but I have found getting better control of my headaches/migraines has taken a monumental effort in a variety of different ways.
I do see my regular doctor and take medications, I take vitamins, I exercise, I watch what I eat, I have reduced my stress levels and I try to control my thoughts.
Honestly, I think I have a physiological tendency toward headaches...no doubt. But I also think that stress and attitude plays a role and since I have no choice in the matter, I am learning to do what I can to control the stress around me and my thoughts and attitudes to feel better.
I take a small amount of Desip. and Topamax. Vitamins...CoQ10, B50, Calcium and Magnesium. There is a good book...Heal Your Headache...123 Program that is good for headache patients. I do NOT believe everything he (the Dr./author) puts forth there, but it is good general advice with reference to an explanation as to what is happening, what might be done and recipes. The author does not advocate taking medicaition, but I think taking medication in small dosages, is a good way to supplement other things to providing overall pain relief.
by the way, I take my Desipramine (small dose...similar to Elavil) at night. Sometimes in the morning, I drink my 1/2 & 1/2 Folgers coffee. I do NOT believe in headache patients drinking much coffee at all...but a little coffee in the morning to help with- grogginess or when one has a bad headache (along with- some Imitrex) is helpful. It's a tricky situation though...caffeine can cause headaches.
Wishing you well...headaches are soooo frustrating...but I am trying to look at it as a wake up call...my HIgher Power telling me to look at myself...take good care of myself.
Wishing you well.