Inositol for headache

by Jim
(Clifton, NJ, USA)

I've had constant daily tension-type headaches all my life. Bilateral, usually centered in the temples; sometimes extending to behind the ears. Usually moderate but annoying, sometimes excruciating.

CT and other tests were normal. Elavil(amitryptiline) and other TCAs had terrible side effects. I take Zoloft for depression, but that worsens the headache problem if anything. Took codeine for 12 years for severe pain, but it stopped being effective. Now take tramadol (Ultram) for unusually bad pain.

I've been trying various herbs and supplements lately (eg, Corydalis, Skullcap, Passion flower). I've read conflicting reports on inositol; some studies say it helps relieve pain (Altern Med Rev 1998 Dec;3(6):432-47, Inositol--clinical applications for exogenous use. Colodny L, Hoffman RL). Some say it has no effect or headache is even a side effect when it was used in depression. Do you think that inositol (or any other supplement) is worth a try as an analgesic or an adjunctive one?

Answer:

Hi Jim,

Sorry you have been having daily headaches for so long! You do not mention whether or not you have seen a headache specialist. If you haven't, I would highly recommend you get to see one.

Chronic tension headache generally responds well to pain killers for only awhile, which is what I think you have discovered already. By pain killers, I mean opiods and Ultram. Anti-spasmotics are generally better and may have to be taken for several months in order to have the best headache benefit.

As far as inositol is concerned, the studies to date have not been large ones, only small studies that would really be considered pilot studies. Most of them seem to have been directed towards psychiatric conditions such as depression and OCD. There seems to be some benefit in improving these conditions but everyone is different and may not respond the same way. The good news is that there does not seem to be a bad side effect profile so it may not hurt to try it.

To date there are no studies looking at inositol and headache as far as I know of, but if you or anyone else comes across one I would certainly be interested in hearing about this.

Since tension type headache is mostly spasmotic in nature I always encourage patients to look at how the neck is affecting their headache profile. Many times neck spasms directly relate to headache pain.

Have you tried Rosemary or Yarrow as alternative therapies? Both of these are anti-spasmotics and may help. Follow the directions on the label and use only organic preparations.

Good luck!
Mary Kay Betz MS RPA-C
Physician Assistant