Some years ago I was diagnose with Paroxysmal hemicrania / ice pick headaches. I've found the worst of it is when I am doing streneous exercise but get the outbreaks near 20 times a day now as it has been getting worst. The doctor has prescribed topomax and indomethacin but we didn't have luck with topomax and indomethacin made me vomit during exercise. At some point I broke my hand playing soccer and they prescribed me tramadol for that and that seemed to help the headaches somewhat. Now after taking this for more than a year I've found I need to take more and more of it for it to work and I have withdrawals when I don't take it and the headaches get worst.

Edit: The last trip they prescribed proponolol and mention Xanax might be an alternative to try as well. Proponolol didn't seem to work and I don't really want to try xanax.