| What is headache?Headache is a term used to | | | | include fatigue, hunger and nervousness. Not |
| describe aching or pain that occurs in one or | | | | all people who get migraines have |
| more areas of the head, face, mouth, or neck. | | | | prodromes.An aura is a complex of |
| Headache involves the network of nerve fibers | | | | neurological symptoms that occur just before |
| in the tissues, muscles, and blood vessels | | | | or at the onset of migraine headache. An aura |
| located in the head and at the base of the | | | | involves a disturbance in vision that may |
| skull.Almost everyone has occasional | | | | consist of brightly colored or blinking |
| headaches, especially when they are sick, | | | | lights in a pattern that moves across the |
| tired or otherwise under stress. Headache is | | | | field of vision. Most patients with migraine |
| the result of pain signals caused by | | | | have attacks without aura. About one in five |
| interactions between the brain, blood | | | | migraine sufferers experiences an |
| vessels, and surrounding nerves. During a | | | | aura.TreatmentHow your migraines are treated |
| headache, the pain comes not from the brain. | | | | will depend on the frequency and severity of |
| It comes from specific nerves surrounding the | | | | attacks. People who have a headache several |
| skull, head muscles, and blood vessels that | | | | times per year often respond well to |
| are activated and send pain signals, | | | | nonprescription pain relievers.There are two |
| interpreted by the brain as a headache. The | | | | types of medications to treat migraines: |
| reasons why these nerves are activated are | | | | |
| not clearly understood. Most headaches go | | | | |
| away on their own or are easily treated with | | | | |
| over the counter (OTC) drugs.Headache | | | | abortive medications - drugs that are taken |
| typesThere are two main categories of | | | | when a headache starts |
| headache: primary and secondary.The major | | | | |
| types of primary headaches include: | | | | preventive medications - drugs that are |
| | | | taken every day to prevent migraines |
| | | | |
| | | | Abortive MedicationsMigraine-specific |
| Tension headache | | | | abortive medications usually are necessary |
| | | | for moderate to severe migraine headaches. |
| Cluster headache | | | | When possible, an abortive medication should |
| | | | be taken immediately after an aura or |
| Migraine | | | | migraine headache starts. However overusing |
| | | | abortive medications can lead to chronic |
| Primary headaches are not caused by other | | | | headaches, that occur day after day without a |
| underlying medical conditions. More than 90% | | | | specific cause or diagnosis. Several |
| of headaches are primary.SecondarySecondary | | | | prescription and nonprescription drugs are |
| headaches result from other medical | | | | used as abortive medications: aspirin, |
| conditions, such as cerebrovascular disease, | | | | ibuprofen (Advil, Apsifen, Motrin, Nuprin and |
| head trauma, infection, tumor, and metabolic | | | | other brand names) or naproxen (Aleve, |
| disorder. These account for fewer than 10% of | | | | Anaprox, Naprosyn)Effective agents available |
| all headaches. Head pain also can result from | | | | by prescription include: |
| syndromes involving the eyes, ears, neck, | | | | |
| teeth, or sinuses. In these cases, the | | | | |
| underlying condition must be diagnosed and | | | | |
| treated. Also, certain types of medication | | | | Triptans - sumatriptan (Imitrex), |
| produce headache as a side effect.Many people | | | | naratriptan (Amerge), zolmitriptan (Zomig) |
| have occasional headaches that get better on | | | | and rizatriptan (Maxalt). Triptan drugs are |
| their own or go away with OTC drug treatment. | | | | effective in 60% to 65% of patients, |
| Most of these people never see a healthcare | | | | completely or significantly relieving |
| provider for their headaches, however, there | | | | migraine pain and associated symptoms within |
| are several circumstances in which an | | | | 2 hours of administration. Triptans reduce |
| evaluation by a physician may be useful or | | | | inflammation and constrict the blood vessels. |
| important: | | | | The triptan with the longest history of use |
| | | | is sumatriptan (Imitrex). |
| | | | |
| | | | Ergots - sublingual ergotamine (Ergomar) and |
| Headaches that are getting worse over time | | | | dihydroergotamine (Migranal). Ergots cause |
| | | | constriction of blood vessels, but ergots |
| Severe headaches that start suddenly | | | | tend to cause more constriction of vessels in |
| | | | the heart and other parts of the body than |
| Headaches that start after a head injury | | | | the triptans, and their effects on the heart |
| | | | are more prolonged than the triptans. Ergots |
| Headaches that always occur on the same side | | | | are not as safe as the triptans. |
| of the head | | | | |
| | | | Midrin. It is a combination of isometheptene |
| Headaches that are not responding to | | | | (a blood vessel constrictor), acetaminophen |
| treatment | | | | (a pain reliever), and dichloralphenazone (a |
| | | | mild sedative) |
| Severe headaches that interrupt work or the | | | | |
| enjoyment of daily activities | | | | Preventive MedicationsPreventive medication |
| | | | are prescribed when migraine attacks that |
| Daily headaches | | | | don't respond well to abortive medications or |
| | | | adverse reactions to abortive medications |
| Aggravated by exertion, coughing, bending, | | | | occur, migraine attacks occur too often, |
| or sexual activity | | | | complicated migraines. Many drugs are listed |
| | | | as potentially useful to prevent recurrent |
| Tension HeadacheTension headaches are the | | | | migraine attacks. The drugs in the following |
| most common type of headaches. They affect up | | | | classes are useful to prevent recurrent |
| to 75% of all headache sufferers. Tension | | | | migraine attacks: |
| headache is usually episodic but may be | | | | |
| chronic, occurring daily or almost daily for | | | | |
| more than 15 days a month. This type of | | | | |
| headache is linked with tension in neck and | | | | Beta-blockers. Propranolol (Inderal) and |
| scalp muscles, affecting blood flow within | | | | nadolol (Corgard) have a good track record of |
| the skull.Tension headaches often start in | | | | being safe and effective. Metoprolol |
| the afternoon or early evening. The pain is | | | | (Lopressor) and atenolol (Tenormin) are |
| typically on both sides of the head, pressing | | | | reasonable alternatives. Beta-blockers have |
| or tightening. Some people get tension | | | | been used for many years to prevent migraine |
| headaches in response to stressful events. | | | | headaches. It is not known how beta-blockers |
| Tension headaches usually do not get worse | | | | prevent migraine headaches. |
| with physical activity (such as walking or | | | | |
| climbing stairs).TreatmentThe occasional | | | | Tricyclic antidepressants. These medications |
| tension headache can be alleviated by a hot | | | | are very effective, but often have |
| shower, massage, sleep, and through patient | | | | troublesome side effects such as sedation, |
| recognition and avoidance of stress | | | | blurred vision, dry mouth and constipation. |
| factors.For episodic tension headaches that | | | | The first choice is often amitriptyline |
| occur less than three times per week, OTC | | | | (Elavil). Nortriptyline (Pamelor, Aventyl), |
| pain relievers such as aspirin, acetaminophen | | | | doxepin (Sinequan), imipramine (Tofranil) |
| (Tylenol) or ibuprofen (Advil, Motrin) are | | | | also can be tried. |
| convenient and effective. Combination | | | | |
| products of pain medication with caffeine may | | | | Anticonvulsants. Of the drugs in this class, |
| help some people, but also may be habit | | | | valproate (Depakote, Epival) has the best |
| forming. Use of any OTC pain reliever should | | | | evidence to support using it for prevention. |
| be limited to no more than two or three days | | | | Gabapentin (Neurontin) and topiramate |
| per week. If pain medications are overused, | | | | (Topamax) also are effective. It is not known |
| rebound headaches may occur on the days that | | | | how anticonvulsants work to prevent migraine |
| medications are not taken.Chronic tension | | | | headaches. |
| headaches are more difficult to treat, | | | | |
| because rebound headaches are common when | | | | Serotonin antagonists. Methysergide |
| pain relievers are stopped. The most | | | | (Sansert) has been available for many years |
| effective medications for treatment of | | | | and is very effective. Methysergide prevents |
| chronic tension headaches are tricyclic | | | | migraine headaches by constricting blood |
| antidepressants (amitriptyline HCl, doxepin | | | | vessels and reducing inflammation of the |
| HCl, nortriptyline HCl). However, it is often | | | | blood vessels. However, this medication has |
| more effective to prevent these headaches | | | | side effects that are potentially very |
| than to treat them.Some people are able to | | | | serious and therefore is not widely used. |
| treat their tension headaches without | | | | |
| medications. An ice compress, a heating pad | | | | Rebound HeadacheIncreasing headache over |
| or a massage to any tight areas in the neck | | | | time with repeated use of pain medicines can |
| and shoulders can be extremely helpful. | | | | lead to a rebound headache. The headache is |
| Relaxation techniques, such as deep breathing | | | | typically located on both sides of the head |
| exercises or acupuncture, may help to | | | | and is described as a pressing or tightening |
| decrease the frequency of headaches.Cluster | | | | type of pain. When headache sufferers use too |
| HeadacheCluster headaches are relatively | | | | much pain medicine, their headaches often |
| rare, affecting about 1% of the population. | | | | recur. This leads to a repeated cycle of |
| They are distinct from migraine and tension | | | | taking more medicines and still having |
| headaches. Cluster headaches primarily affect | | | | headaches. Rebound headache may appear if: |
| men between the ages of 20 and 40. Attacks | | | | |
| usually occur in a series, or "clusters" of 1 | | | | |
| - 8 headaches per day over a period of | | | | |
| several weeks to months. The pain is | | | | taking analgesics on 15 or more days per |
| extremely severe but the attack is brief, | | | | month for more than 3 months |
| lasting 15 minutes to 3 hours. The pain of | | | | |
| cluster headache almost always occurs on one | | | | taking opioid or combination medication 10 |
| side of the head. During cluster headaches, | | | | or more days per month for more than 3 months |
| the eye on the same side as the pain may | | | | |
| become teary or droopy or develop a small | | | | When analgesics are discontinued, the |
| pupil. There may also be nasal congestion on | | | | headache may get worse for several days and |
| the affected side of the face.About 80% of | | | | it may take up to 30 days to recover from the |
| cluster headaches occur at night, and in | | | | rebound process. Non-drug approaches, such as |
| about 70% of patients, drinking alcohol can | | | | biofeedback, relaxation therapy, and |
| trigger a cluster headache. Unlike migraine | | | | exercise, can be helpful in reducing both |
| sufferers, those with cluster headache often | | | | headache frequency and need for |
| feel better if they keep moving during the | | | | medication.Headache TriggersTriggers are not |
| headache.TreatmentIt is difficult to stop the | | | | direct causes of the headache, but they |
| pain of a cluster headache that is in | | | | facilitate or provoke the beginning of an |
| progress, because the headache usually | | | | attack. Anything that stimulates the pain |
| disappears by the time the patient reaches | | | | receptors in the head and neck can cause a |
| the emergency room or doctor's office. | | | | headache. Some of the more common triggers |
| Because the onset of cluster headache attacks | | | | for headache: |
| is rapid and may occur several times a day, | | | | |
| the best approach to treatment is with daily | | | | |
| preventive drugs to decrease the severity and | | | | |
| frequency of headaches. Lithium (Carbolith, | | | | Emotional triggers: problems at work, |
| Duralith, Lithane, Lithobid, Lithonate and | | | | success at work or school, anticipation, |
| others) and verapamil (Isoptin, Calan, | | | | anxiety, an emotional crisis, a new job. |
| Chronovera, Verelan, Novo-Veramil) are the | | | | Emotions can bring on headaches, keep them |
| two drugs that are most effective at | | | | going, and make them worse. Emotions don't |
| accomplishing this. Other drugs used for this | | | | cause your headaches, they just make you more |
| purpose include prednisone (Deltasone, | | | | vulnerable to them. |
| Meticorten, Orasone 1, Winpred and others), | | | | |
| cyproheptadine (Periactin) and methysergide | | | | Environmental triggers: bright light, |
| (Sansert). Prophylactic medications usually | | | | different kinds of aromas like perfume, |
| are begun early during a cycle of cluster | | | | tobacco, odors (such as gasoline), loud |
| headaches and continued for two weeks longer | | | | noises, altitude, barometric pressure |
| than the usual cycle.Abortive treatments | | | | changes. |
| include inhalation of 100% oxygen. Inhaling | | | | |
| 100% oxygen for about 15 minutes through a | | | | Stress triggers: strenuous exercise, |
| facemask has proven to be helpful when it is | | | | excessive physical work at the work place or |
| done at the first signs of an attack. This | | | | at school, physical sickness, not enough |
| oxygen must be prescribed by a doctor and | | | | sleep or too much sleep |
| obtained through a medical supplier. Other | | | | |
| types of drugs that may be effective when | | | | Chemical triggers: changes in hormone levels |
| used at the outset of cluster pain include | | | | (that occur during the premenstrual period, |
| the triptans (Imitrex, Maxalt, Zomig, Axert, | | | | during the post-menstrual period), low blood |
| Amerge), ergotamine (Cafergot) and | | | | sugar. |
| indomethacin (Indocin).Migraine | | | | |
| HeadacheMigraine headaches are less common | | | | Food and beverage triggers: caffeine, |
| than tension headaches. About 6% of all men | | | | alcohol (especially red wine), hard cheese, |
| and 18% of all women experience a migraine | | | | vinegar, hot dogs, chocolate, nuts, MSG |
| headache at some time. Migraine headache | | | | (monosodium glutamate), pizza, pork. Foods |
| occurs on one or both sides of the head. The | | | | containing nitrites as preservatives can also |
| pain is typically pulsating or throbbing in | | | | trigger headaches. Fasting or missing meals |
| nature. Nausea, with or without vomiting, as | | | | is a major headache trigger. |
| well as sensitivity to light and sound often | | | | |
| accompany migraines. Migraines are made worse | | | | Changes in the weather can change body |
| by activity, bright lights and bright noises. | | | | chemistry, and have been known to trigger |
| In most cases, migraine attacks are | | | | headaches. |
| occasional, or sometimes as often as once or | | | | |
| twice a week, but not daily. Women who have | | | | Heavy cigarette smoking. |
| migraines often find that their headaches | | | | |
| occur or worsen around the time of their | | | | Yury Bayarski is the author of - a |
| menstrual periods.One unique feature of | | | | prescription drug price comparison website. |
| migraines is an unusual sensation that a | | | | Please follow this link if you would like to |
| migraine is about to occur. This sensation is | | | | read more about headache relief prescription |
| called a prodrome. Prodrome symptoms can | | | | drugs. |