I have had 5 h/as in jan, 5 in feb, 6 in march, and 8 this month..i am taking 25mg topomax and zyrtec (cetirizine) for terrible unilateral h/as behind my right eye?

Ganglion block?: I offer sphenopalatine ganglion block to my chronic migraine patients. It's not painful, just a little unpleasant (tearing for a minute); there are no side effects; nasal bleeding is the most frequent risk. Very often the relief is dramatic. That being said, eliminating triggers is always the first step.

Your Topomax: Dosage may not be high enough. Most effective for reducing migraine frequency at doses of 100mg per day. Some individuals may experience side effects, which prevents them from getting to that dose; however, there are other things to consider.