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Headache Medications: Pros and ConsThere are several classes of drugs that are effective as headaches medications. Most of them are quite effective as migraine headache treatments to prevent migraines.Most of the time, medications for headache can be taken at doses MUCH LOWER than doses used for other problems. Unfortunately, some people are frightened of headache medications and will refuse to even try them, believing they will get every side effect listed. Let's review the most commonly used headache medications from a sensible point of view, OK?
Anti-Seizure Medications
This is probably the most effective class of drugs for lowering frequency and pain level of headaches. I have used the drugs I discuss on thousands (!) of patients and am pretty familiar with how the patients respond. These drugs are appropriate for you if: 1. You have 1 or 2 severe, disabling headaches per month and/or.. 2. You have 2 to 3 headaches per week. The most effective drugs are as follows:
Topamax,
Depakote,
Keppra,
and Zonegran.
Anti-DepressantsNow don't freak out! This class of drugs is very effective not only to treat mood but also to alieviate pain.Almost 85% of all chronic pain patients have depression and/or anxiety to some degree.
Chronic illness
such as fibromyalgia, MS, diabetes, and headaches can all lead to depression if the condition is more than six months old.
OpiodsOpiods: This includes drugs such as hydrocodone, Lortabs, Tylenol with Codeine, Fiorcet and
Ultram for headache.
Many times these medications are handed out by well meaning health care professionals to try and treat a patient in acute pain of headache. Unfortunately, too many times patients become addicted to these drugs as the headaches become worse and worse. Using these medications more than three times per week for headaches can actually make the headache syndrome WORSE! If you have had this happen you may feel like you are taking a "cocktail" of pain meds each day.
Anti-PsychoticsOnce again don't freak out! These medications are not first line in treating constant chronic daily headache, but they are effective when nothing else has worked. They tend to dampen the pain pathways in the brain and reduce the frequency and pain level of the headaches.The most promising in the class currently for headaches are Seroquel and Zyprexa and once again I use very low doses.
Botox
Botox for migraine is an exciting newer option for you if you have migraines that have failed to respond to the above options. Several tiny doses of Botox are placed across the forhead, just under the skin. If it works, count on it to last up to three months. It may not cure migraines, but it can reduce your amount of medication you take. Discuss this with your doctor and find a clinician skilled in doing Botox.
Beta-BlockersBeta-blockers such as Inderal(propranalol) were also one of the earlier drugs found to be effective in preventing migraine. Unfortunately, it is not as effective as anti-seizure medications, but that does not mean it might not work for you.For severe migraines during pregancy, beta-blockers in very low doses can be effective. The important thing to remember when pregnant and considering a drug, is that severe pain, nausea and vomiting is not good for you or the baby. Pain raises adrenaline levels, causing an increase in blood pressure and repetative vomiting causes dehydration. It is best to treat the headaches and keep you and your baby healthy.
Calcium Channel BlockersThis is another class of anti-hypertensives like beta-blockers that may help treat migraine. This drug in particular is effective if you have a lot of vertigo or spinning feelings with your headaches.The most commonly used drug for headaches is verapamil and is not used in higher doses for migraine as it is for cluster headaches. Like the beta-blockers, this drug has the potential to lower your blood pressure and in addition may cause constipation.
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