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Chronic headache, severe reactionsto medications

I have had 4 concussions between Feb 2012 and Dec. 2013. I was able to recover from each of these but after attempting to return to my teaching job in Feb 2014, I have been unable to recover from constant headache at the 5/6 level. My symptoms were made worse with Prednisone and Topamax taken in March and May 2014. This makes me leery of trying other medications, although I know a medication may be the only way to get out of my acute condition. I am confined to my bedroom, unable to walk, talk, listen, or do any cognitive function without worsening my headache. What would you recommend as a way out of this?

Answer:

First of all, if you are confined to your bedroom I would say your headache is much worse than a 5 or 6/10. That is a moderate headache and people can function with that.

As you can see on my site, amitryptiline is the drug of choice for the post-concussive patient. You should also have an MRI at this point with SWI or susceptibility weighted imaging. This can only be done on a more sophisticated MRI machine, called a 3T magnet MRI.

Also, consider asking your neurologist about the medications. Many people are started at a dose too high for them which causes side effects. We generally start amitryptiline at 10 mg 2 hours before bed. You should also be given a round of steroid for a week or two to break the cycle of pain.

Good luck!
Mary Kay Betz MS RPA-C

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