Post Concussion Syndrome: Medications?

by Gail
(Westminster Md.)

Hi Mary Kay,

My daughter was recovering from a concussion which she is now recovering from post concussion syndrome. She has severe migraine headaches with other concussion symptoms present.

We went back to her Dr. and he gave her another MRI, and put her on Depakote ER 500mg tab with bed rest.

My question is how long does she have to be on this medication? She says she feels better with her headaches. She thinks the medication is giving her some side effects that she is not liking. She says she wants to go off of this.

I was just wondering how long Doctors leave patients on this type of medication for this problem. Thanks for being such a great support system through all of this!

Answer

Hi Gail,

Generally speaking, in the world of headache treatment, a patient is taken off of medication when they are are having only one mild to moderate headache per month, that abortive medication readily takes care of.

I am not sure that your daughter is there yet. Depakote ER is a good medication for daily headaches and severe migraines. Although I do not use it for post concussive syndrome, that doesn't mean it wouldn't work for your daughter.

If 500 mg is too much, ask the doctor if she can back down to 250mg for 2-3 weeks rather than stop it. Then at that point try the 500 again and she may have less side effects. At that point the brain has gotten used to the drug.

Generally the main side effect of depakote for headaches is sedation so I advise patients to take it after dinner.

Post concussive syndrome can take many months to settle down and unfortunately if patients do not understand this, they tend to get a little impatient and want to stop therapy before it has had a good chance to work.

Good luck!
Mary Kay Betz, MS RPA-C