3 imperatives to transform health care in America. You're invited to watch it live

Free

E-newsletter

Subscribe to Housecall

Our weekly general interest
e-newsletter keeps you up to date on a wide variety of health topics.

Sign up now

Treatments and drugs

By Mayo Clinic staff

Treatment for any underlying diseases or conditions often stops frequent headaches. When no underlying diseases or conditions are present, treatment focuses on preventing the pain before it starts.

Specific prevention strategies vary, depending on which type of headache you have and whether medication overuse is contributing to these headaches. If you're taking pain relievers more than three days a week, the first step in treatment may be to stop using these drugs. When you're ready to begin preventive therapy, your doctor may recommend:

  • Antidepressants. Tricyclic antidepressants — such as nortriptyline (Pamelor, Aventyl Hydrochloride) — can be used to treat chronic headaches. These medications can also help treat the depression, anxiety and sleep disturbances that often accompany chronic daily headaches. Other antidepressants, such as the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac, Sarafem), may be helpful for treatment of depression and anxiety, too.
  • Beta blockers. These drugs, commonly used to treat high blood pressure, are also a mainstay for preventing episodic migraines. Some beta blockers include atenolol (Tenormin), metoprolol (Lopressor, Toprol-XL) and propranolol (Inderal, Innopran XL). Sometimes beta blockers are prescribed in combination with antidepressants, and this combination is sometimes more effective than either medication on its own.
  • Anti-seizure medications. Some anti-seizure drugs seem to prevent migraines. These medications may be used to prevent chronic daily headaches as well. Options may include gabapentin (Neurontin, Gralise), topiramate (Topamax) and divalproex sodium (Depakote).
  • NSAIDs. Prescription nonsteroidal anti-inflammatory drugs — such as naproxen (Anaprox, Naprosyn, Naprelan) — may be helpful, especially if you're going through withdrawal from other pain relievers. They may also be used periodically when the headache is more severe.
  • Botulinum toxin. Botulinum toxin type A (Botox) injections provide relief for some people and may especially be a viable option for people who don't tolerate daily medication well.

Unfortunately, some chronic daily headaches remain resistant to all medications.

Alternative medicine Tests and diagnosis
References
  1. Halker RB, et al. Chronic daily headache: An evidence-based and systematic approach to a challenging problem. Neurology. 2011;76:S37.
  2. Chronic daily headache and chronic migraine. American Headache Society. http://www.americanheadachesociety.org/assets/1/7/NAP_for_Web_-_CDH___Chronic_Migraine.pdf. Accessed Dec. 3, 2011.
  3. Chronic daily headache. National Headache Foundation. http://www.headaches.org/education/Headache_Topic_Sheets/Chronic_Daily_Headache. Accessed Dec. 3, 2011.
  4. Boes CJ, et al. Headache and other craniofacial pain. In: Bradley WG, et al. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa.: Butterworth-Heinemann Elsevier; 2008. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7506-7525-3..50111-4&isbn=978-0-7506-7525-3&sid=1244789901&uniqId=307655043-3#4-u1.0-B978-0-7506-7525-3..50111-4--cesec76. Accessed Dec. 3, 2011.
  5. IHS Classification ICHD-II: Chronic tension-type headache. International Headache Society. http://ihs-classification.org/en/02_klassifikation/02_teil1/02.03.00_tension.html. Accessed Dec. 2, 2011.
  6. IHS Classification ICHD-II: New daily persistent headache (NDPH). International Headache Society. http://ihs-classification.org/en/02_klassifikation/02_teil1/04.08.00_other.html. Accessed Dec. 2, 2011.
  7. IHS Classification ICHD-II: Hemicrania continua. International Headache Society. http://ihs-classification.org/en/02_klassifikation/02_teil1/04.07.00_other.html. Accessed Dec. 2, 2011.
  8. Headache: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/headache/detail_headache.htm. Accessed Dec. 2, 2011.
  9. Goadsby PJ, et al. Headache. In: Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9094791. Accessed Dec. 1, 2011.
  10. Bigal ME, et al. Obesity and chronic daily headache. Current Pain and Headache Report. Published online Nov. 11, 2011.
  11. Ahmed K, et al. Experience with botulinum toxin type A in medically intractable pediatric chronic daily headache. Pediatric Neurology. 2010;43:316.
  12. Headaches and CAM. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/pain/headachefacts.htm. Accessed Dec. 3, 2011.
  13. Meditation: An introduction. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/meditation/overview.htm. Accessed Dec. 3, 2011.
  14. Vargas BB, et al. The face of chronic migraine: Epidemiology, demographics and treatment strategies. Neurology Clinics. 2009;27:467.
  15. Rains J. Sleep disorders and headache. American Headache Society. http://www.achenet.org/resources/sleep_disorders_and_headache/. Accessed Dec. 2, 2011.
  16. Swanson JW (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 10, 2011.
DS00646 March 15, 2012

© 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

  • Reprints
  • Print

  • Share on:

  • Email

Advertisement


Text Size: smaller largerlarger