Materiały źródłowe

• #1 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  Chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least three months. […] Several prophylactic treatments for chronic daily headache can reduce headache frequency and severity, as well as improve overall quality of life. Nonpharmacologic treatments include relaxation techniques, cognitive behavior therapy, acupuncture, osteopathic manipulation, and cervical exercises. Pharmacologic therapies include amitriptyline, gabapentin, onabotulinumtoxinA, propranolol, tizanidine, topiramate, and valproate. […] Biofeedback and relaxation techniques can decrease the frequency and severity of chronic daily headaches, and reduce medication use. […] Cognitive behavior therapy in group or individualized settings has been shown to reduce headache frequency and severity, and to improve overall quality of life.

• #2 Chronic Headaches – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559083/

  Chronic headache is not a single disease entity but an umbrella term that encompasses all chronic headaches. The International Headache Society defines chronic daily headaches (CDH) as „15 or more headache episodes per month for at least three months.” […] This activity reviews the evaluation and treatment of chronic headaches and explains the role of the interprofessional team in evaluating, treating, managing, and improving care for patients with this condition. […] Treatment and management of chronic headache disorders depend upon the underlying etiology and may require an interprofessional approach. […] Chronic migraine treatment should begin with setting the expectation that headache frequency and severity will decrease, but headaches will not be eliminated. Prophylactic pharmacologic treatment should be used. First-line therapy includes beta-blockers, anticonvulsants, and antidepressants. The most commonly used medications are propranolol, topiramate, and amitriptyline. […] Amitriptyline, a tricyclic antidepressant, is recommended as the first-line treatment for chronic tension headaches. […] Patient education about the potential for overuse of analgesic medication to lead to headache progression is key. […] Indomethacin is the drug of choice for paroxysmal hemicrania, hemicrania continua, primary stabbing headache, hypnic headache, and Valsalva-induced headaches (e.g., cough headache, exercise headache).

• #3 Chronic daily headaches – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/diagnosis-treatment/drc-20370897

  Treatment for an underlying condition often stops frequent headaches. If no such condition is found, treatment focuses on preventing pain. […] Prevention strategies vary, depending on the type of headache you have and whether medication overuse is contributing to your headaches. If you’re taking pain relievers more than three days a week, the first step might be to wean yourself off these drugs with your doctor’s guidance. […] When you’re ready to begin preventive therapy, your doctor may recommend: […] Antidepressants. Tricyclic antidepressants such as nortriptyline (Pamelor) can be used to treat chronic headaches. These medications can also help treat the depression, anxiety and sleep disturbances that often accompany chronic daily headaches. […] Other antidepressants, such as the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac, Sarafem, others), might help in treating depression and anxiety, but have not been shown to be more effective than placebo for headaches.

• #4 Chronic daily headaches | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872

  If you have a headache most days, you might have one of the most disabling headache conditions, chronic daily headaches. Aggressive treatment and long-term management might help. […] The constant nature of chronic daily headaches makes them one of the most disabling headache conditions. Aggressive initial treatment and steady, long-term management might reduce pain and lead to fewer headaches. […] Treatment for an underlying condition often stops frequent headaches. If no such condition is found, treatment focuses on preventing pain. […] Prevention strategies vary, depending on the type of headache you have and whether medication overuse is contributing to your headaches. If you’re taking pain relievers more than three days a week, the first step might be to wean yourself off these drugs with your doctor’s guidance.

• #5 Chronic daily headaches – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/diagnosis-treatment/drc-20370897

  Treatment for an underlying condition often stops frequent headaches. If no such condition is found, treatment focuses on preventing pain. […] Prevention strategies vary, depending on the type of headache you have and whether medication overuse is contributing to your headaches. If you’re taking pain relievers more than three days a week, the first step might be to wean yourself off these drugs with your doctor’s guidance. […] When you’re ready to begin preventive therapy, your doctor may recommend: […] Antidepressants. Tricyclic antidepressants such as nortriptyline (Pamelor) can be used to treat chronic headaches. These medications can also help treat the depression, anxiety and sleep disturbances that often accompany chronic daily headaches. […] Other antidepressants, such as the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac, Sarafem, others), might help in treating depression and anxiety, but have not been shown to be more effective than placebo for headaches.

• #6 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache. […] Gabapentin (Neurontin) increases the number of headache-free days in patients with chronic daily headache when compared with placebo. […] Valproate (Depacon) and topiramate (Topamax) reduce the rate of migraine attacks by at least 50%. […] Propranolol reduces the frequency of migraine headache, although its effectiveness for chronic migraine is unclear. […] Several behavioral modifications are recommended for patients with chronic daily headache. These include cessation of caffeine and tobacco use, improved sleep hygiene, diet changes, and regular mealtimes. […] Acupuncture also has proven effective for reducing the frequency of headaches in persons with both migraine and tension-type headache.

• #7 Chronic Tension Headache: Causes and Treatment

  https://patient.info/brain-nerves/headache-leaflet/chronic-tension-headache

  Chronic tension headache is a condition where you have a tension headache on at least 15 days every month for at least three months. A medicine called amitriptyline may help to prevent the headaches from occurring. […] Painkillers such as paracetamol, aspirin, and ibuprofen can be useful to treat tension headaches when they occur. […] Amitriptyline is the medicine most commonly used to treat chronic tension headaches. This medicine is not a painkiller and so does not take away a headache if a headache develops. It needs to be taken every day to reduce how often headaches occur. […] There is some evidence that acupuncture, particularly when combined with medical therapy, can be helpful in the treatment of chronic daily headaches. […] CBT can be a helpful add-on in the treatment of chronic daily headache. Behavioural therapies work towards reducing or eliminating the stress which may contribute to the development of chronic tension headaches. […] The aims of preventative treatment are to reduce the number of headaches, or reduce their severity, or both. So, with treatment, the headaches may not go completely, but they will often develop less often and be less severe.

• #8 Chronic daily headaches – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/diagnosis-treatment/drc-20370897

  Treatment for an underlying condition often stops frequent headaches. If no such condition is found, treatment focuses on preventing pain. […] Prevention strategies vary, depending on the type of headache you have and whether medication overuse is contributing to your headaches. If you’re taking pain relievers more than three days a week, the first step might be to wean yourself off these drugs with your doctor’s guidance. […] When you’re ready to begin preventive therapy, your doctor may recommend: […] Antidepressants. Tricyclic antidepressants such as nortriptyline (Pamelor) can be used to treat chronic headaches. These medications can also help treat the depression, anxiety and sleep disturbances that often accompany chronic daily headaches. […] Other antidepressants, such as the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac, Sarafem, others), might help in treating depression and anxiety, but have not been shown to be more effective than placebo for headaches.

• #9 Chronic Headache: Types, Causes, How to Get Relief

  https://www.businessinsider.com/guides/health/conditions-symptoms/chronic-headache

  If you get a headache 15 or more days each month, you most likely have a chronic headache. […] A doctor can help diagnose your chronic headaches and recommend an effective treatment approach. […] You can treat migraine pain with over-the-counter (OTC) painkillers like aspirin, acetaminophen, and ibuprofen. […] If you experience regular migraines, it’s best to ask your primary care doctor about other treatments. They can prescribe medication to help ease your symptoms and prevent or reduce the frequency of chronic migraines, such as: Beta blockers like metoprolol and propranolol, Tricyclic antidepressants like amitriptyline and nortriptyline, Angiotensin blockers like candesartan. […] You can treat the pain associated with chronic tension headaches with OTC painkillers such as aspirin, ibuprofen, and naproxen. Your doctor may also prescribe tricyclic antidepressants such as protriptyline and amitriptyline to reduce the frequency of headache episodes.

• #10 Chronic daily headaches – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/diagnosis-treatment/drc-20370897

  Beta blockers. These drugs, commonly used to treat high blood pressure, are also a mainstay for preventing episodic migraines. […] Anti-seizure medications. Some anti-seizure drugs seem to prevent migraines and might be used to prevent chronic daily headaches, as well. […] NSAIDs. Prescription nonsteroidal anti-inflammatory drugs such as naproxen sodium (Anaprox, Naprelan) might be helpful, especially if you’re withdrawing from other pain relievers. […] Botulinum toxin. OnabotulinumtoxinA (Botox) injections provide relief for some people and might be a viable option for people who don’t tolerate daily medication well. […] The use of one drug is preferred, but if one drug doesn’t work well enough, your doctor might consider combining drugs.

• #11 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache. […] Gabapentin (Neurontin) increases the number of headache-free days in patients with chronic daily headache when compared with placebo. […] Valproate (Depacon) and topiramate (Topamax) reduce the rate of migraine attacks by at least 50%. […] Propranolol reduces the frequency of migraine headache, although its effectiveness for chronic migraine is unclear. […] Several behavioral modifications are recommended for patients with chronic daily headache. These include cessation of caffeine and tobacco use, improved sleep hygiene, diet changes, and regular mealtimes. […] Acupuncture also has proven effective for reducing the frequency of headaches in persons with both migraine and tension-type headache.

• #12 Treatment of chronic daily headache

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3451586/

  Patients with chronic daily headache (CDH) are difficult to treat. A combination of general measures and specific pharmacological treatments is necessary. When possible, pharmacological management should be planned on an outpatient basis. The general protocol should include abrupt discontinuation of the offending symptomatic medications, specific treatment for detoxification, daily nonsteroidal anti-inflammatory drugs (NSAIDs) for about 1 month, triptans only for moderate-severe headache, and prophylactic treatment. Either amitriptyline plus propranolol or valproic acid have been classically recommended for transformed migraine prophylaxis. Refractory patients can respond to a combination of a beta-blocker and valproic acid, possibly due to their complementary mechanisms of action. Recently, the new antiepileptic topiramate has been shown to be especially useful in this indication. At least one-third of patients, however, do not improve. Therefore, the best treatment of this incapacitating entity continues to be its prevention. Preventive measures should include: (1) public information concerning the risk of frequent self-treatment for headaches; (2) inform headache patients of the risk of analgesic overuse/rebound headache; (3) recommend NSAIDs and triptans as symptomatic medications; and (4) active use of preventive medications when headaches begin to increase in frequency.

• #13 Chronic daily headaches – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/diagnosis-treatment/drc-20370897

  Beta blockers. These drugs, commonly used to treat high blood pressure, are also a mainstay for preventing episodic migraines. […] Anti-seizure medications. Some anti-seizure drugs seem to prevent migraines and might be used to prevent chronic daily headaches, as well. […] NSAIDs. Prescription nonsteroidal anti-inflammatory drugs such as naproxen sodium (Anaprox, Naprelan) might be helpful, especially if you’re withdrawing from other pain relievers. […] Botulinum toxin. OnabotulinumtoxinA (Botox) injections provide relief for some people and might be a viable option for people who don’t tolerate daily medication well. […] The use of one drug is preferred, but if one drug doesn’t work well enough, your doctor might consider combining drugs.

• #14 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache. […] Gabapentin (Neurontin) increases the number of headache-free days in patients with chronic daily headache when compared with placebo. […] Valproate (Depacon) and topiramate (Topamax) reduce the rate of migraine attacks by at least 50%. […] Propranolol reduces the frequency of migraine headache, although its effectiveness for chronic migraine is unclear. […] Several behavioral modifications are recommended for patients with chronic daily headache. These include cessation of caffeine and tobacco use, improved sleep hygiene, diet changes, and regular mealtimes. […] Acupuncture also has proven effective for reducing the frequency of headaches in persons with both migraine and tension-type headache.

• #15 New Daily Persistent Headache (NDPH): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24098-new-daily-persistent-headache-ndph

  NDPH is often a difficult condition to treat. Some cases of this condition are easier to treat, especially those with migraine-like symptoms. Tension headache cases are more likely to resist treatment. Time is also a factor, as NDPH is more likely to respond to treatment when treated earlier rather than years after symptoms begin. […] Medications are usually the main way to treat NDPH. However, finding a medication that can treat this condition is often difficult. Some examples of possible medication types include: Antidepressants. Medications like amitriptyline, nortriptyline and venlafaxine, which also treat pain disorders, can sometimes help NDPH. Antiseizure medications. Some examples include gabapentin or topiramate. Botulinum toxin injections (commonly known by the brand name Botox). This drug blocks nerve signals, including pain signals. Other types of nerve blocks can also help. Medications used to prevent migraines. Examples include beta-blockers like propranolol and angiotensin-II receptor blockers like candesartan. Experimental anesthetic/antidepressants. Ketamine, a powerful anesthetic that also sees experimental use in treating resistant depression, can sometimes help NDPH.

• #16 Chronic daily headaches – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/diagnosis-treatment/drc-20370897

  Beta blockers. These drugs, commonly used to treat high blood pressure, are also a mainstay for preventing episodic migraines. […] Anti-seizure medications. Some anti-seizure drugs seem to prevent migraines and might be used to prevent chronic daily headaches, as well. […] NSAIDs. Prescription nonsteroidal anti-inflammatory drugs such as naproxen sodium (Anaprox, Naprelan) might be helpful, especially if you’re withdrawing from other pain relievers. […] Botulinum toxin. OnabotulinumtoxinA (Botox) injections provide relief for some people and might be a viable option for people who don’t tolerate daily medication well. […] The use of one drug is preferred, but if one drug doesn’t work well enough, your doctor might consider combining drugs.

• #17 Treatment of chronic daily headache

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3451586/

  Patients with chronic daily headache (CDH) are difficult to treat. A combination of general measures and specific pharmacological treatments is necessary. When possible, pharmacological management should be planned on an outpatient basis. The general protocol should include abrupt discontinuation of the offending symptomatic medications, specific treatment for detoxification, daily nonsteroidal anti-inflammatory drugs (NSAIDs) for about 1 month, triptans only for moderate-severe headache, and prophylactic treatment. Either amitriptyline plus propranolol or valproic acid have been classically recommended for transformed migraine prophylaxis. Refractory patients can respond to a combination of a beta-blocker and valproic acid, possibly due to their complementary mechanisms of action. Recently, the new antiepileptic topiramate has been shown to be especially useful in this indication. At least one-third of patients, however, do not improve. Therefore, the best treatment of this incapacitating entity continues to be its prevention. Preventive measures should include: (1) public information concerning the risk of frequent self-treatment for headaches; (2) inform headache patients of the risk of analgesic overuse/rebound headache; (3) recommend NSAIDs and triptans as symptomatic medications; and (4) active use of preventive medications when headaches begin to increase in frequency.

• #18 Chronic daily headaches – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/diagnosis-treatment/drc-20370897

  Beta blockers. These drugs, commonly used to treat high blood pressure, are also a mainstay for preventing episodic migraines. […] Anti-seizure medications. Some anti-seizure drugs seem to prevent migraines and might be used to prevent chronic daily headaches, as well. […] NSAIDs. Prescription nonsteroidal anti-inflammatory drugs such as naproxen sodium (Anaprox, Naprelan) might be helpful, especially if you’re withdrawing from other pain relievers. […] Botulinum toxin. OnabotulinumtoxinA (Botox) injections provide relief for some people and might be a viable option for people who don’t tolerate daily medication well. […] The use of one drug is preferred, but if one drug doesn’t work well enough, your doctor might consider combining drugs.

• #19 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  Other pharmacologic options include tizanidine (Zanaflex), certain anticonvulsants, propranolol, and onabotulinumtoxinA (Botox). […] There is evidence that tizanidine, an alpha2-adrenergic agonist, is effective for chronic migraine and chronic tension-type headache, reducing severity, frequency, and duration. […] Valproate (Depacon) and topiramate (Topamax) are anticonvulsants that can reduce the frequency of chronic migraine by 50%. […] OnabotulinumtoxinA is an injectable neurotoxin that has been shown to reduce headache frequency in those with chronic migraines, although evidence is lacking for chronic tension-type headache.

• #20 New Treatment Options for Headaches | Cedars-Sinai

  https://www.cedars-sinai.org/blog/new-headache-treatment-options.html

  Additionally, patients on this new class of drugs are able to get onto a full dose earlier than the adjustment period required to test your reaction and build up to classic headache medications. […] Patients need to try other treatments before insurance will approve one of the new ones. […] Botox is FDA-approved for chronic migraines in adults who have at least 15 headache days a month with each headache lasting four or more hours. […] Treatments are repeated once every three months, Dr. Shadbehr says, and most patients see a decrease in headache days after the first two sessions. […] Trigger point injections target muscles to address co-occurring myofascial and chronic neck and shoulder pain, and nerve blocks address concurrent neuralgias and help break up frequent headache cycles. […] There are individualized treatment plans available to help alleviate chronic headaches and improve your quality of life.

• #21 Chronic Daily Headaches | Jan & Tom Lewis Migraine Treatment Program | Barrow Neurological InstituteGroup 9Group 9Group 49

  https://www.barrowneuro.org/condition/chronic-daily-headaches/

  Chronic Daily Headaches Treatments […] Treatments that try to stop or reduce headache symptoms before or shortly after they start have a greater chance of reducing the frequency of chronic headaches than treatments administered after headache symptoms have begun. […] Abortive medications—the name for drugs used to treat headache symptoms that have already begun—can cause medication overuse “rebound” headaches if taken too frequently. This can start a cycle in which the medicine, while providing brief relief, ends up causing more headaches over time. […] Some medications originally intended for other uses can be effective at preventing chronic daily headaches, such as: Anti-depressants, Beta blockers, Anti-seizure medications. […] Botox can be used for the prevention of chronic migraines, but insurance companies usually require people to try preventative medications before they will cover Botox. Botox injections are performed in 31 sites on the head and neck every 12 weeks and can be very effective in reducing the frequency and severity of migraines.

• #22 Why Am I Getting Frequent Headaches? – Scripps Health

  https://www.scripps.org/news_items/3239-why-do-i-get-frequent-headaches

  There are many effective treatments to relieve symptoms and prevent future attacks, adds Robert Bonakdar, MD, a pain specialist at the Scripps Center for Integrative Medicine. Treatments may include medication, biofeedback and other therapies. […] When over-the-counter medicine fails to work and headaches become more frequent, medication and other therapies may be prescribed. […] Medications to prevent frequent migraines include antidepressants and Botox injections and newer medications that target a neuropeptide known as calcitonin gene-related peptide, which is believed to play a key role in migraine development. […] For treatment of migraines as they occur, your doctor may prescribe triptans for relief. […] Medication for frequent headaches may be combined with non-medication options, such as biofeedback, relaxation, bio stimulation and diet therapy.

• #23 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  Other pharmacologic options include tizanidine (Zanaflex), certain anticonvulsants, propranolol, and onabotulinumtoxinA (Botox). […] There is evidence that tizanidine, an alpha2-adrenergic agonist, is effective for chronic migraine and chronic tension-type headache, reducing severity, frequency, and duration. […] Valproate (Depacon) and topiramate (Topamax) are anticonvulsants that can reduce the frequency of chronic migraine by 50%. […] OnabotulinumtoxinA is an injectable neurotoxin that has been shown to reduce headache frequency in those with chronic migraines, although evidence is lacking for chronic tension-type headache.

• #24 16 Chronic Migraine Treatments

  https://www.health.com/condition/headaches-and-migraines/chronic-migraine-treatments

  The American Headache Society considers several antidepressants to be „probably effective” in preventing migraines. People often use amitriptyline, an antidepressant, to prevent migraines. […] Blood pressure medications, like beta-blockers, can be „very effective” at preventing migraines, said Dr. Dyess. […] Botox (botulinum toxin) injections prevent migraines by blocking nerves and weakening muscles around your face and neck. […] Research has found that blood levels of calcitonin gene-related peptide (CGRP), a chemical messenger, elevate when you have a migraine. There are two classes of CGRP inhibitors that help block migraines. […] CGRP receptor antagonists are oral medicines that stop the inflammation that leads to a migraine, said Dr. Dyess. […] The Food and Drug Administration has approved CGRP receptor antagonists for the acute treatment of migraine.

• #25 Constant headaches: What they could mean and how to manage

  https://blog.walgreens.com/health/pain-management/constant-headaches-what-they-could-mean-and-how-to-manage.html

  Non-steroidal anti-inflammatory drugs (NSAIDs): There are prescription and over-the-counter NSAIDs available. These pain relievers may be recommended for easing the pain associated with constant headaches when they occur. […] Tricyclic antidepressants: These medications raise levels of serotonin and norepinephrine in the brain, and they may reduce the frequency of headaches. […] Botulinum toxin A: Injections of onabotulinumtoxinA (Botox) may be recommended for people with constant migraines who dont respond well to other medications. […] CGRP receptor antagonists: This relatively newer category of medications is highly effective in treating and preventing acute migraines. They work by blocking a pain neurotransmitter involved in the perception of headaches.

• #26 New Daily Persistent Headache (NDPH): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24098-new-daily-persistent-headache-ndph

  NDPH is often a difficult condition to treat. Some cases of this condition are easier to treat, especially those with migraine-like symptoms. Tension headache cases are more likely to resist treatment. Time is also a factor, as NDPH is more likely to respond to treatment when treated earlier rather than years after symptoms begin. […] Medications are usually the main way to treat NDPH. However, finding a medication that can treat this condition is often difficult. Some examples of possible medication types include: Antidepressants. Medications like amitriptyline, nortriptyline and venlafaxine, which also treat pain disorders, can sometimes help NDPH. Antiseizure medications. Some examples include gabapentin or topiramate. Botulinum toxin injections (commonly known by the brand name Botox). This drug blocks nerve signals, including pain signals. Other types of nerve blocks can also help. Medications used to prevent migraines. Examples include beta-blockers like propranolol and angiotensin-II receptor blockers like candesartan. Experimental anesthetic/antidepressants. Ketamine, a powerful anesthetic that also sees experimental use in treating resistant depression, can sometimes help NDPH.

• #27 New Daily Persistent Headache

  https://practicalneurology.com/diseases-diagnoses/headache-pain/new-daily-persistent-headache/31897/

  Attempts to break the cycle of constant pain, potentially making the disorder more responsive to treatment, have included the use of steroids and antiseizure medications. A study showed the use of methylprednisolone and sodium valproate followed by preventive therapy for at least 3 months was effective. Intravenous therapies used for migraine (eg, dihydroergotamine) may be less effective in NDPH. Other therapies such as intravenous lidocaine or ketamine have been reported to successfully treat NDPH. Peripheral nerve blocks (eg, occipital nerve blocks) may provide immediate relief but are not likely to provide long-term improvement.

• #28 Chronic Headaches – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559083/

  Chronic headache is not a single disease entity but an umbrella term that encompasses all chronic headaches. The International Headache Society defines chronic daily headaches (CDH) as „15 or more headache episodes per month for at least three months.” […] This activity reviews the evaluation and treatment of chronic headaches and explains the role of the interprofessional team in evaluating, treating, managing, and improving care for patients with this condition. […] Treatment and management of chronic headache disorders depend upon the underlying etiology and may require an interprofessional approach. […] Chronic migraine treatment should begin with setting the expectation that headache frequency and severity will decrease, but headaches will not be eliminated. Prophylactic pharmacologic treatment should be used. First-line therapy includes beta-blockers, anticonvulsants, and antidepressants. The most commonly used medications are propranolol, topiramate, and amitriptyline. […] Amitriptyline, a tricyclic antidepressant, is recommended as the first-line treatment for chronic tension headaches. […] Patient education about the potential for overuse of analgesic medication to lead to headache progression is key. […] Indomethacin is the drug of choice for paroxysmal hemicrania, hemicrania continua, primary stabbing headache, hypnic headache, and Valsalva-induced headaches (e.g., cough headache, exercise headache).

• #29 Chronic Daily Headache – London Headache Centre

  https://londonheadachecentre.co.uk/heahache-information-for-patients/chronic-daily-headache/

  Chronic migraine may be treated with a wide selection of prophylactic treatments, including tricyclic antidepressants, beta-blockers, anti-epileptics, and Botox. […] Chronic cluster headache may respond to verapamil, topiramate, lithium, methysergide, or melatonin. […] Chronic paroxysmal hemicrania or hemicrania continua should respond to indometacin. […] All chronic trigeminal autonomic cephalgias may respond to occipital nerve stimulation. […] Although CDH is often challenging to deal with, accuracy in diagnosis and perseverance in treatment can lead to significant improvements in virtually all cases.

• #30 Patient education: Headache treatment in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/headache-treatment-in-adults-beyond-the-basics/print

  In many people, headaches can be well controlled with a combination of medicines and complementary therapies. Treatment is most successful when it is tailored to your needs. […] The management of chronic daily headache depends on the type of headache and whether medication overuse is a factor. […] Chronic migraine – The treatment of chronic migraine should focus on preventive therapy while avoiding migraine triggers and limiting the use of acute headache medications to avoid medication-overuse headache. Preventive treatments include medicines, behavioral therapy, and lifestyle changes (eg, good sleep hygiene, regular exercise, and dietary changes to avoid triggers). Management often requires the simultaneous use of these different treatments. […] Chronic tension-type headache – For chronic tension-type headache, effective treatment involves the use of daily preventive medications (eg, tricyclic antidepressants), behavioral therapies, and lifestyle changes (eg, regular exercise and dietary changes). Like chronic migraine, the combined use of these interventions is often best.

• #31 Chronic Headache: Types, Causes, How to Get Relief

  https://www.businessinsider.com/guides/health/conditions-symptoms/chronic-headache

  Depending on your specific situation, you may be able to treat this headache with OTC painkillers such as ibuprofen or naproxen. Other options your doctor may recommend include cognitive behavioral therapy (CBT), acupuncture, and physical therapy. […] You do have options for treatment, though. Depending on your specific symptoms, your doctor may prescribe: Antiseizure medications like topiramate or gabapentin, Antidepressants like nortriptyline and amitriptyline, Beta blockers like candesartan and propranolol, Botox injections, Ketamine. […] Although hemicrania continua typically doesn’t respond to most painkillers, it can be treated with indomethacin, a medication that fights inflammation. Your doctor can prescribe this medication if they diagnose this type of headache. […] A healthcare professional may diagnose this type of headache if you experience head pain for 15 or more days each month for three consecutive months, while taking OTC and prescription pain medications.

• #32 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  Chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least three months. […] Several prophylactic treatments for chronic daily headache can reduce headache frequency and severity, as well as improve overall quality of life. Nonpharmacologic treatments include relaxation techniques, cognitive behavior therapy, acupuncture, osteopathic manipulation, and cervical exercises. Pharmacologic therapies include amitriptyline, gabapentin, onabotulinumtoxinA, propranolol, tizanidine, topiramate, and valproate. […] Biofeedback and relaxation techniques can decrease the frequency and severity of chronic daily headaches, and reduce medication use. […] Cognitive behavior therapy in group or individualized settings has been shown to reduce headache frequency and severity, and to improve overall quality of life.

• #33 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  There is a growing body of evidence to suggest that various psychotherapeutic regimens can be effective in decreasing disability for those with chronic daily headache, including Internet-based biofeedback and relaxation techniques that have been shown to decrease headache frequency and severity, and medication use. […] There is somewhat stronger evidence for the use of cognitive behavior therapy for chronic daily headache, both in group and individualized settings. […] Several prophylactic drug therapies have been studied for the treatment of chronic daily headache. […] Amitriptyline, a tricyclic antidepressant, reduces headache duration and severity for chronic tension-type headache compared with placebo, and is thought also to be effective for other forms of chronic daily headache.

• #34 Chronic daily headaches | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872

  For many people, complementary or alternative therapies offer relief from headache pain. […] Acupuncture. This ancient technique uses hair-thin needles inserted into several areas of your skin at defined points. […] Biofeedback. You might be able to control headaches by becoming more aware of and then changing certain bodily responses, such as muscle tension, heart rate and skin temperature. […] Massage. Massage can reduce stress, relieve pain and promote relaxation. […] Before trying complementary or alternative therapy, discuss the risks and benefits with your doctor.

• #35 Why Am I Getting Frequent Headaches? – Scripps Health

  https://www.scripps.org/news_items/3239-why-do-i-get-frequent-headaches

  Biofeedback uses electronic monitoring to help teach individuals how to control certain physical responses, such as muscle tension. […] Manual and massage therapy can be especially helpful for those with significant muscle tension or neck stiffness related to headache, Dr. Bonakdar says. […] Biostimulation is a broad term that encompasses therapies like acupuncture, which uses needles to stimulate specific points of the body to alleviate pain. […] With a treatment course, acupuncture has been found to be as helpful as medication in the prevention of migraines, Dr. Bonakdar says. […] Diet is just one component of headache management, he adds. Its important to look at the whole person to develop a treatment plan that includes a healthy lifestyle, integrative therapies and when appropriate medication.

• #36 Chronic Tension Headache: Causes and Treatment

  https://patient.info/brain-nerves/headache-leaflet/chronic-tension-headache

  Chronic tension headache is a condition where you have a tension headache on at least 15 days every month for at least three months. A medicine called amitriptyline may help to prevent the headaches from occurring. […] Painkillers such as paracetamol, aspirin, and ibuprofen can be useful to treat tension headaches when they occur. […] Amitriptyline is the medicine most commonly used to treat chronic tension headaches. This medicine is not a painkiller and so does not take away a headache if a headache develops. It needs to be taken every day to reduce how often headaches occur. […] There is some evidence that acupuncture, particularly when combined with medical therapy, can be helpful in the treatment of chronic daily headaches. […] CBT can be a helpful add-on in the treatment of chronic daily headache. Behavioural therapies work towards reducing or eliminating the stress which may contribute to the development of chronic tension headaches. […] The aims of preventative treatment are to reduce the number of headaches, or reduce their severity, or both. So, with treatment, the headaches may not go completely, but they will often develop less often and be less severe.

• #37 Headaches: Causes, types, and treatment

  https://www.medicalnewstoday.com/articles/73936

  A 2021 study found acupuncture therapy to be more effective than medications in treating chronic tension-type headaches, similar to the findings of a 2018 study. […] Meanwhile, a 2020 study found that using CBT decreased the frequency of migraine in children and adolescents. […] Some evidence has suggested that migraine episodes may be more likely to occur when a person has low levels of magnesium and vitamin D. […] While the evidence is not conclusive, a person may find that taking 400-500 milligrams of magnesium oxide per day helps prevent episodes.

• #38 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  Chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least three months. […] Several prophylactic treatments for chronic daily headache can reduce headache frequency and severity, as well as improve overall quality of life. Nonpharmacologic treatments include relaxation techniques, cognitive behavior therapy, acupuncture, osteopathic manipulation, and cervical exercises. Pharmacologic therapies include amitriptyline, gabapentin, onabotulinumtoxinA, propranolol, tizanidine, topiramate, and valproate. […] Biofeedback and relaxation techniques can decrease the frequency and severity of chronic daily headaches, and reduce medication use. […] Cognitive behavior therapy in group or individualized settings has been shown to reduce headache frequency and severity, and to improve overall quality of life.

• #39 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  There is a growing body of evidence to suggest that various psychotherapeutic regimens can be effective in decreasing disability for those with chronic daily headache, including Internet-based biofeedback and relaxation techniques that have been shown to decrease headache frequency and severity, and medication use. […] There is somewhat stronger evidence for the use of cognitive behavior therapy for chronic daily headache, both in group and individualized settings. […] Several prophylactic drug therapies have been studied for the treatment of chronic daily headache. […] Amitriptyline, a tricyclic antidepressant, reduces headache duration and severity for chronic tension-type headache compared with placebo, and is thought also to be effective for other forms of chronic daily headache.

• #40 Chronic daily headaches | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872

  For many people, complementary or alternative therapies offer relief from headache pain. […] Acupuncture. This ancient technique uses hair-thin needles inserted into several areas of your skin at defined points. […] Biofeedback. You might be able to control headaches by becoming more aware of and then changing certain bodily responses, such as muscle tension, heart rate and skin temperature. […] Massage. Massage can reduce stress, relieve pain and promote relaxation. […] Before trying complementary or alternative therapy, discuss the risks and benefits with your doctor.

• #41 Headaches: Causes, types, and treatment

  https://www.medicalnewstoday.com/articles/73936

  A 2021 study found acupuncture therapy to be more effective than medications in treating chronic tension-type headaches, similar to the findings of a 2018 study. […] Meanwhile, a 2020 study found that using CBT decreased the frequency of migraine in children and adolescents. […] Some evidence has suggested that migraine episodes may be more likely to occur when a person has low levels of magnesium and vitamin D. […] While the evidence is not conclusive, a person may find that taking 400-500 milligrams of magnesium oxide per day helps prevent episodes.

• #42 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache. […] Gabapentin (Neurontin) increases the number of headache-free days in patients with chronic daily headache when compared with placebo. […] Valproate (Depacon) and topiramate (Topamax) reduce the rate of migraine attacks by at least 50%. […] Propranolol reduces the frequency of migraine headache, although its effectiveness for chronic migraine is unclear. […] Several behavioral modifications are recommended for patients with chronic daily headache. These include cessation of caffeine and tobacco use, improved sleep hygiene, diet changes, and regular mealtimes. […] Acupuncture also has proven effective for reducing the frequency of headaches in persons with both migraine and tension-type headache.

• #43 Management of chronic headaches – Wikipedia

  https://en.wikipedia.org/wiki/Management_of_chronic_headaches

  Another non-medicinal treatment, which does not require at-home exercises, is acupuncture. Acupuncture involves a certified acupuncturist picking particular points on the body to insert acupuncture needles; these points may differ on an individual basis. […] Relaxation training is another form of non-pharmacological treatment for chronic headache. Relaxation training helps to reduce internal tension, allowing a person to control headaches triggered by stress. […] Many physicians also recommend changes in diet to treat chronic headaches. Many people with chronic headaches fail to recognize foods or beverages as headache factors, because the consumption may not consistently cause headaches or the headaches may be delayed. […] Also, behavioral therapy and psychological therapy are suggested treatments to reduce chronic headaches. Behavioral therapy and psychological therapy relate closely in their treatment methods, which include a combination of identifying headache stressors, biofeedback, relaxation training, and cognitive-behavioral therapy.

• #44 Chronic daily headaches | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872

  For many people, complementary or alternative therapies offer relief from headache pain. […] Acupuncture. This ancient technique uses hair-thin needles inserted into several areas of your skin at defined points. […] Biofeedback. You might be able to control headaches by becoming more aware of and then changing certain bodily responses, such as muscle tension, heart rate and skin temperature. […] Massage. Massage can reduce stress, relieve pain and promote relaxation. […] Before trying complementary or alternative therapy, discuss the risks and benefits with your doctor.

• #45 Why Am I Getting Frequent Headaches? – Scripps Health

  https://www.scripps.org/news_items/3239-why-do-i-get-frequent-headaches

  Biofeedback uses electronic monitoring to help teach individuals how to control certain physical responses, such as muscle tension. […] Manual and massage therapy can be especially helpful for those with significant muscle tension or neck stiffness related to headache, Dr. Bonakdar says. […] Biostimulation is a broad term that encompasses therapies like acupuncture, which uses needles to stimulate specific points of the body to alleviate pain. […] With a treatment course, acupuncture has been found to be as helpful as medication in the prevention of migraines, Dr. Bonakdar says. […] Diet is just one component of headache management, he adds. Its important to look at the whole person to develop a treatment plan that includes a healthy lifestyle, integrative therapies and when appropriate medication.

• #46 Chronic Daily Headache: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html

  Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache. […] Gabapentin (Neurontin) increases the number of headache-free days in patients with chronic daily headache when compared with placebo. […] Valproate (Depacon) and topiramate (Topamax) reduce the rate of migraine attacks by at least 50%. […] Propranolol reduces the frequency of migraine headache, although its effectiveness for chronic migraine is unclear. […] Several behavioral modifications are recommended for patients with chronic daily headache. These include cessation of caffeine and tobacco use, improved sleep hygiene, diet changes, and regular mealtimes. […] Acupuncture also has proven effective for reducing the frequency of headaches in persons with both migraine and tension-type headache.

• #47 Patient education: Headache treatment in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/headache-treatment-in-adults-beyond-the-basics/print

  In many people, headaches can be well controlled with a combination of medicines and complementary therapies. Treatment is most successful when it is tailored to your needs. […] The management of chronic daily headache depends on the type of headache and whether medication overuse is a factor. […] Chronic migraine – The treatment of chronic migraine should focus on preventive therapy while avoiding migraine triggers and limiting the use of acute headache medications to avoid medication-overuse headache. Preventive treatments include medicines, behavioral therapy, and lifestyle changes (eg, good sleep hygiene, regular exercise, and dietary changes to avoid triggers). Management often requires the simultaneous use of these different treatments. […] Chronic tension-type headache – For chronic tension-type headache, effective treatment involves the use of daily preventive medications (eg, tricyclic antidepressants), behavioral therapies, and lifestyle changes (eg, regular exercise and dietary changes). Like chronic migraine, the combined use of these interventions is often best.

• #48 Is It Normal To Get Headaches Everyday? | Grady Health

  https://www.gradyhealth.org/blog/is-it-normal-to-get-headaches-everyday/

  Get a good night’s sleep. Most adults need seven to eight hours of sleep a night. […] Get regular exercise. Physical activity can improve your physical and mental well-being and reduce stress. […] Reduce stress. Stress is a common trigger of chronic headaches. […] When Should You See A Doctor? Occasional headaches usually require no special medical attention. However, you should consult a doctor if you: Consistently have two or more headaches a week. […] If you suffer from more common chronic headaches, visit your doctor for advice.

• #49 18 Remedies to Get Rid of Headaches Naturally

  https://www.healthline.com/nutrition/headache-remedies

  Foods containing nitrates and nitrites have been shown to trigger headaches in some people. […] A 2021 review that included three randomized control trials found that treatment with ginger supplements helped reduce pain in people with migraine. […] A number of studies have shown that exercise could help significantly reduce migraine intensity, frequency, and duration. […] If you’re looking for ways to prevent headaches, the following evidence-based tips may help: Stay hydrated throughout the day is a simple way to reduce the risk of headaches while benefiting your overall health. […] If you’re experiencing frequent headaches or a lasting, severe headache, it’s critical that you seek medical care. […] A doctor can help rule out potential underlying causes of your headaches and give you the right care.

• #50 Chronic daily headaches | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872

  For many people, complementary or alternative therapies offer relief from headache pain. […] Acupuncture. This ancient technique uses hair-thin needles inserted into several areas of your skin at defined points. […] Biofeedback. You might be able to control headaches by becoming more aware of and then changing certain bodily responses, such as muscle tension, heart rate and skin temperature. […] Massage. Massage can reduce stress, relieve pain and promote relaxation. […] Before trying complementary or alternative therapy, discuss the risks and benefits with your doctor.

• #51 18 Remedies to Get Rid of Headaches Naturally

  https://www.healthline.com/nutrition/headache-remedies

  Studies have shown that treatment with supplemental magnesium, in many different doses and forms, may help reduce both the frequency and the severity of migraine headaches. […] While having an alcoholic drink may not cause a headache in most people, studies have shown that alcohol can trigger migraines in about one-third of those who experience frequent headaches. […] Sleep deprivation can be detrimental to your health in many ways and may even cause headaches in some people. […] Studies suggest that consuming histamine may cause migraines in those who are sensitive to it. […] Research suggests that peppermint, lavender, and eucalyptus essential oils are especially helpful when you have a headache. […] Several studies have shown that certain B vitamin supplements, including riboflavin (B2), folate, B12, and pyridoxine (B6) may reduce headache symptoms.

• #52 Chronic migraine – The Migraine TrustVisualV1 – SearchVisualV1 – CrossVisualV1 – Home VisualV1 – CrossVisualV1 – Arrow

  https://migrainetrust.org/understand-migraine/types-of-migraine/chronic-migraine/

  Some people with chronic migraine find non-drug treatments helpful. Often these work best when used alongside other treatment options. Non-drug options include: supplements – such as riboflavin (B2), magnesium or co-enzyme Q10, acupuncture, devices such as Cefaly or gammaCore. […] For some people with chronic migraine reviewing triggers and looking at lifestyle changes can be helpful. Disrupted sleep and stress are common triggers.

• #53 Frequent Headaches: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0401/p419.html

  The optimal strategy for medication withdrawal is unclear. […] A comprehensive management plan requires pharmacologic and nonpharmacologic interventions, attention to inciting and exacerbating factors, advice on healthy lifestyle, attention to comorbid conditions, and education for patients and family members on headache management. […] Patients with frequent headaches require both prophylactic and acute pharmacologic treatment. […] Guidelines stress that behavioral and physical therapies should be integrated with pharmacologic treatment of frequent headaches. […] Regularly scheduled follow-up is necessary to monitor the patient’s headache pattern and make adjustments to the management plan.

• #54 Frequent Headaches: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0401/p419.html

  The mean annual cost of chronic migraine (including lost productivity and medical care) is more than three times the cost of episodic migraine (approximately $8,250 vs. $2,650). […] Identifying patients with risk factors for escalating from episodic to chronic headaches can help physicians and patients be alert for early signs of escalation and aware of the need to address modifiable risk factors, especially medications. […] The strongest predictive factors for headache progression are frequent headache episodes at baseline and medication overuse. […] Chronic pain, especially musculoskeletal pain, and obesity are strongly associated with chronification. […] Addressing medication overuse may be the most important intervention for increasingly frequent headaches. […] About 30% to 50% of patients who develop chronic headaches have MOH, which is defined as headache on 15 or more days per month in a patient with preexisting primary headache, developing as a consequence of regular overuse of acute or symptomatic headache medication for more than three months.

• #55 Patient education: Headache treatment in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/headache-treatment-in-adults-beyond-the-basics/print

  Medication-overuse headache – This happens when headaches (of any type) lead to a cycle of taking medication to treat pain, then headache recurring when the medication wears off, then taking more medication. […] The approach to treating medication-overuse headache involves understanding the cycle that is happening, stopping the medication being overused, and working with your healthcare provider to establish an appropriate headache treatment and prevention plan.

• #56 Patient education: Headache treatment in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/headache-treatment-in-adults-beyond-the-basics

  Chronic tension-type headache – For chronic tension-type headache, effective treatment involves the use of daily preventive medications (eg, tricyclic antidepressants), behavioral therapies, and lifestyle changes (eg, regular exercise and dietary changes). Like chronic migraine, the combined use of these interventions is often best. […] Medication-overuse headache – This happens when headaches (of any type) lead to a cycle of taking medication to treat pain, then headache recurring when the medication wears off, then taking more medication. […] The approach to treating medication-overuse headache involves understanding the cycle that is happening, stopping the medication being overused, and working with your healthcare provider to establish an appropriate headache treatment and prevention plan.

• #57 Chronic daily headache |

  https://sydneynorthneurology.com.au/chronic-daily-headache/

  The doctors at SNNN specialise in the management of severe headache and migraine. Make an appointment today. […] How is chronic daily headache treated? […] Chronic daily headache is treated differently depending on whether or not the condition occurs as a result of medication overuse, as medication overusers typically fail to respond to medicines used to treat migraine. […] The aim of treatment is to reduce headache frequency and severity, but also to reduce the quantity of medication used and increase the efficacy of medication when it is used. Treatment success is defined as a reduction in headache days 50% within 6 months. […] Withdrawal of the overused medication is the first step in treating individuals with medication overuse headache. Alternate medications become effective once the withdrawal effect has resolved; however, in the immediate term withdrawing individuals will experience withdrawal symptoms which must be managed.

• #58 Chronic daily headache (incorporating chronic migraine and medication overuse headache) | Healthengine Blog

  https://healthinfo.healthengine.com.au/chronic-daily-headache-incorporating-chronic-migraine-and-medication-overuse-headache

  Chronic daily headache is thought to most typically occur as a result of medication overuse. […] Chronic daily headache is treated differently depending on whether or not the condition occurs as a result of medication overuse, as medication overusers typically fail to respond to medicines used to treat migraine. […] The aim of treatment is to reduce headache frequency and severity, but also to reduce the quantity of medication used and increase the efficacy of medication when it is used. […] Withdrawal of the overused medication is the first step in treating individuals with medication overuse headache. […] Prophylactic treatment, that is the use of preventative medications for chronic migraine (without medication overuse) aims to reduce the frequency of acute attacks, lessen the impairment the individuals experience during an attack and reduce the use of acute medication. […] Preventing medication overuse is the primary measure for preventing medication overuse headache, the most common type of daily headache.

• #59 Chronic daily headaches – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/diagnosis-treatment/drc-20370897

  Beta blockers. These drugs, commonly used to treat high blood pressure, are also a mainstay for preventing episodic migraines. […] Anti-seizure medications. Some anti-seizure drugs seem to prevent migraines and might be used to prevent chronic daily headaches, as well. […] NSAIDs. Prescription nonsteroidal anti-inflammatory drugs such as naproxen sodium (Anaprox, Naprelan) might be helpful, especially if you’re withdrawing from other pain relievers. […] Botulinum toxin. OnabotulinumtoxinA (Botox) injections provide relief for some people and might be a viable option for people who don’t tolerate daily medication well. […] The use of one drug is preferred, but if one drug doesn’t work well enough, your doctor might consider combining drugs.

• #60

  https://link.springer.com/article/10.1007/s11940-996-0015-9

  The therapy of chronic daily headache (CDH) is complex and involves a combination of drugs, supportive psychotherapy, nondrug therapy, tender-loving care, and tough love. […] The use of preventative antimigraine therapy is a major component of treatment of this condition. […] The treatment plan must be individualized for each patient. […] Taking a little extra time to talk with patients and discuss medications, procedures, and goals and objectives may pay bigger dividends in the therapeutic relationship later in the course of treatment.

• #61 New Daily Persistent Headache

  https://practicalneurology.com/articles/2022-may/new-daily-persistent-headache

  Because there is a lack of evidence for any specific treatment for NDPH, management of the disorder remains challenging. Medications that are effective for migraine are not always effective for NDPH, and no pharmacologic treatment of NDPH had a greater than 50% response rate in case series. Analgesics and migraine-specific therapies (eg, triptans) are usually ineffective. A trial-and-error approach may be necessary, as well as combination therapy (see Rational Polypharmacy for Migraine in this issue), considering the refractory nature of NDPH. Most clinicians treat NDPH based on its phenotype, and 2 basic strategies are the following: 1) long-term preventive therapies including pharmacologic, behavioral, or neuromodulation modalities; and 2) short-term interventions to break the cycle of continuous headache and improve long-term outcomes (Table 3).

• #62 New Daily Persistent Headache

  https://practicalneurology.com/articles/2022-may/new-daily-persistent-headache

  Because there is a lack of evidence for any specific treatment for NDPH, management of the disorder remains challenging. Medications that are effective for migraine are not always effective for NDPH, and no pharmacologic treatment of NDPH had a greater than 50% response rate in case series. Analgesics and migraine-specific therapies (eg, triptans) are usually ineffective. A trial-and-error approach may be necessary, as well as combination therapy (see Rational Polypharmacy for Migraine in this issue), considering the refractory nature of NDPH. Most clinicians treat NDPH based on its phenotype, and 2 basic strategies are the following: 1) long-term preventive therapies including pharmacologic, behavioral, or neuromodulation modalities; and 2) short-term interventions to break the cycle of continuous headache and improve long-term outcomes (Table 3).

• #63 Frequent Headaches: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0401/p419.html

  The optimal strategy for medication withdrawal is unclear. […] A comprehensive management plan requires pharmacologic and nonpharmacologic interventions, attention to inciting and exacerbating factors, advice on healthy lifestyle, attention to comorbid conditions, and education for patients and family members on headache management. […] Patients with frequent headaches require both prophylactic and acute pharmacologic treatment. […] Guidelines stress that behavioral and physical therapies should be integrated with pharmacologic treatment of frequent headaches. […] Regularly scheduled follow-up is necessary to monitor the patient’s headache pattern and make adjustments to the management plan.

• #64 Chronic Daily Headache Management: 10 Steps for Treatment Success – MPR

  https://www.empr.com/home/features/chronic-daily-headache-management-10-steps-for-treatment-success/2/

  To prevent MOH, simple analgesics should be used 14 days per month and targeted pharmacotherapy should be used 10 days per month. An additional factor to consider when treating CDH is the route of administration of an agent. Intranasal, injectable, or oral acute medications provide a faster onset compared to other medications and can be utilized for patients who suffer from sudden exacerbations of HAs. Lifestyle changes should also be initiated in a patient diagnosed with CDH. These modifications include routine exercise, stress management, behavioral therapy and counseling, avoidance of triggers, optimizing sleep patterns, and maintaining balanced meals. […] In step 9 of the program, education regarding treatment should be provided. Teaching patients about their condition and setting realistic goals is an important step within this program. It is also recommended that a patient begin a headache diary, which should be maintained on a daily basis with details about headache days, treatment use, and treatment response and reviewed at every visit with the provider. The final step of the program involves initiation of follow-up for continuous patient improvement. It is important for clinicians to work closely with their patients to ensure treatment success over time.

• #65 New Daily Persistent Headache (NDPH): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24098-new-daily-persistent-headache-ndph

  NDPH is often a difficult condition to treat. Some cases of this condition are easier to treat, especially those with migraine-like symptoms. Tension headache cases are more likely to resist treatment. Time is also a factor, as NDPH is more likely to respond to treatment when treated earlier rather than years after symptoms begin. […] Medications are usually the main way to treat NDPH. However, finding a medication that can treat this condition is often difficult. Some examples of possible medication types include: Antidepressants. Medications like amitriptyline, nortriptyline and venlafaxine, which also treat pain disorders, can sometimes help NDPH. Antiseizure medications. Some examples include gabapentin or topiramate. Botulinum toxin injections (commonly known by the brand name Botox). This drug blocks nerve signals, including pain signals. Other types of nerve blocks can also help. Medications used to prevent migraines. Examples include beta-blockers like propranolol and angiotensin-II receptor blockers like candesartan. Experimental anesthetic/antidepressants. Ketamine, a powerful anesthetic that also sees experimental use in treating resistant depression, can sometimes help NDPH.

• #66 New daily persistent headache | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/new-daily-persistent-headache/

  NDPH is treated like the headache it resembles, generally chronic migraine or chronic tension-type headache. There is no specific treatment for NDPH – it is difficult to control, and often these types of headaches are treated like migraines. […] Some common medications have been shown to be effective in studies of adult and children, including amitriptyline, gabapentin, pregabalin, propranolol and topiramate. […] There are no controlled trials of preventative treatment and in those who display migraine-like features, it may be worth using migraine prophylactic treatment to reduce the risk of attacks occurring. […] Nevertheless, the current cornerstones of therapy are lifestyle modification, education, preventative medication, avoiding daily painkillers and attention to routine. […] As NDPH is often difficult to treat, it often requires a multi-faceted approach.

• #67 What is the difference between NDPH and Chronic Migraine?

  https://www.migraineagain.com/difference-ndph-chronic-migraine/

  New daily persistent headache is a primary headache disorder, and, as its name suggests, it is a chronic daily headache. […] The final point is very important: NDPH is diagnosed only after other headache disorders that can include chronic migraine are ruled out. […] Although NDPH is a distinct headache disorder, it has long been underrecognized. […] According to Treppendahl, New daily persistent headache is very stubborn and difficult to treat, and it’s a very small percentage of the population. Generally, new daily persistent headache treatment mirrors the treatment of the type of headache it resembles. If NDPH presents similar to migraine, then treatment will follow migraine treatment guides. If NDPH more closely mirrors tension-type headache, then tension-type treatment would be appropriate. […] New daily persistent headache treatment can be difficult and depends on the unique symptoms of an individual’s headache.

• #68 New Daily Persistent Headache (NDPH): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24098-new-daily-persistent-headache-ndph

  Treating NDPH yourself is difficult, especially when you don’t have a diagnosis. That’s because this condition often won’t respond to standard headache treatments. That means over-the-counter medications, and even many prescription medications, aren’t effective at stopping NDPH. […] Unfortunately, there’s no way to know whether or not different treatments will work. It’s common for many medications to have no effect on NDPH. In general, it takes about six to eight weeks for a preventive treatment plan to take effect. Your healthcare provider is the best person to talk to you about how fast a medication if effective should work. They can tell you what you can and should expect, and what you should do if treatment isn’t effective.

• #69 Patient education: Headache treatment in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/headache-treatment-in-adults-beyond-the-basics/print

  In many people, headaches can be well controlled with a combination of medicines and complementary therapies. Treatment is most successful when it is tailored to your needs. […] The management of chronic daily headache depends on the type of headache and whether medication overuse is a factor. […] Chronic migraine – The treatment of chronic migraine should focus on preventive therapy while avoiding migraine triggers and limiting the use of acute headache medications to avoid medication-overuse headache. Preventive treatments include medicines, behavioral therapy, and lifestyle changes (eg, good sleep hygiene, regular exercise, and dietary changes to avoid triggers). Management often requires the simultaneous use of these different treatments. […] Chronic tension-type headache – For chronic tension-type headache, effective treatment involves the use of daily preventive medications (eg, tricyclic antidepressants), behavioral therapies, and lifestyle changes (eg, regular exercise and dietary changes). Like chronic migraine, the combined use of these interventions is often best.

• #70 Patient education: Headache treatment in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/headache-treatment-in-adults-beyond-the-basics

  Chronic daily headache treatment means a headache that is present for more than 15 days per month for at least three months. It is not a type of headache but a category that includes different types; most people with chronic daily headache have migraine or tension-type headaches. […] The management of chronic daily headache depends on the type of headache and whether medication overuse is a factor. […] Chronic migraine – The treatment of chronic migraine should focus on preventive therapy while avoiding migraine triggers and limiting the use of acute headache medications to avoid medication-overuse headache. Preventive treatments include medicines, behavioral therapy, and lifestyle changes (eg, good sleep hygiene, regular exercise, and dietary changes to avoid triggers). Management often requires the simultaneous use of these different treatments.

• #71 Chronic Headaches – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559083/

  Chronic headache is not a single disease entity but an umbrella term that encompasses all chronic headaches. The International Headache Society defines chronic daily headaches (CDH) as „15 or more headache episodes per month for at least three months.” […] This activity reviews the evaluation and treatment of chronic headaches and explains the role of the interprofessional team in evaluating, treating, managing, and improving care for patients with this condition. […] Treatment and management of chronic headache disorders depend upon the underlying etiology and may require an interprofessional approach. […] Chronic migraine treatment should begin with setting the expectation that headache frequency and severity will decrease, but headaches will not be eliminated. Prophylactic pharmacologic treatment should be used. First-line therapy includes beta-blockers, anticonvulsants, and antidepressants. The most commonly used medications are propranolol, topiramate, and amitriptyline. […] Amitriptyline, a tricyclic antidepressant, is recommended as the first-line treatment for chronic tension headaches. […] Patient education about the potential for overuse of analgesic medication to lead to headache progression is key. […] Indomethacin is the drug of choice for paroxysmal hemicrania, hemicrania continua, primary stabbing headache, hypnic headache, and Valsalva-induced headaches (e.g., cough headache, exercise headache).

• #72 Patient education: Headache treatment in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/headache-treatment-in-adults-beyond-the-basics/print

  In many people, headaches can be well controlled with a combination of medicines and complementary therapies. Treatment is most successful when it is tailored to your needs. […] The management of chronic daily headache depends on the type of headache and whether medication overuse is a factor. […] Chronic migraine – The treatment of chronic migraine should focus on preventive therapy while avoiding migraine triggers and limiting the use of acute headache medications to avoid medication-overuse headache. Preventive treatments include medicines, behavioral therapy, and lifestyle changes (eg, good sleep hygiene, regular exercise, and dietary changes to avoid triggers). Management often requires the simultaneous use of these different treatments. […] Chronic tension-type headache – For chronic tension-type headache, effective treatment involves the use of daily preventive medications (eg, tricyclic antidepressants), behavioral therapies, and lifestyle changes (eg, regular exercise and dietary changes). Like chronic migraine, the combined use of these interventions is often best.

• #73 Patient education: Headache treatment in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/headache-treatment-in-adults-beyond-the-basics

  Chronic tension-type headache – For chronic tension-type headache, effective treatment involves the use of daily preventive medications (eg, tricyclic antidepressants), behavioral therapies, and lifestyle changes (eg, regular exercise and dietary changes). Like chronic migraine, the combined use of these interventions is often best. […] Medication-overuse headache – This happens when headaches (of any type) lead to a cycle of taking medication to treat pain, then headache recurring when the medication wears off, then taking more medication. […] The approach to treating medication-overuse headache involves understanding the cycle that is happening, stopping the medication being overused, and working with your healthcare provider to establish an appropriate headache treatment and prevention plan.

• #74 Chronic Headaches – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559083/

  Chronic headache is not a single disease entity but an umbrella term that encompasses all chronic headaches. The International Headache Society defines chronic daily headaches (CDH) as „15 or more headache episodes per month for at least three months.” […] This activity reviews the evaluation and treatment of chronic headaches and explains the role of the interprofessional team in evaluating, treating, managing, and improving care for patients with this condition. […] Treatment and management of chronic headache disorders depend upon the underlying etiology and may require an interprofessional approach. […] Chronic migraine treatment should begin with setting the expectation that headache frequency and severity will decrease, but headaches will not be eliminated. Prophylactic pharmacologic treatment should be used. First-line therapy includes beta-blockers, anticonvulsants, and antidepressants. The most commonly used medications are propranolol, topiramate, and amitriptyline. […] Amitriptyline, a tricyclic antidepressant, is recommended as the first-line treatment for chronic tension headaches. […] Patient education about the potential for overuse of analgesic medication to lead to headache progression is key. […] Indomethacin is the drug of choice for paroxysmal hemicrania, hemicrania continua, primary stabbing headache, hypnic headache, and Valsalva-induced headaches (e.g., cough headache, exercise headache).

• #75 Treatment of chronic daily headache | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1007/s10194-004-0118-1

  Patients with chronic daily headache (CDH) are difficult to treat. A combination of general measures and specific pharmacological treatments is necessary. […] When possible, pharmacological management should be planned on an outpatient basis. The general protocol should include abrupt discontinuation of the offending symptomatic medications, specific treatment for detoxification, daily nonsteroidal anti-inflammatory drugs (NSAIDs) for about 1 month, triptans only for moderate-severe headache, and prophylactic treatment. Either amitriptyline plus propranolol or valproic acid have been classically recommended for transformed migraine prophylaxis. Refractory patients can respond to a combination of a beta-blocker and valproic acid, possibly due to their complementary mechanisms of action. Recently, the new antiepileptic topiramate has been shown to be especially useful in this indication. At least one-third of patients, however, do not improve. Therefore, the best treatment of this incapacitating entity continues to be its prevention. Preventive measures should include: (1) public information concerning the risk of frequent self-treatment for headaches; (2) inform headache patients of the risk of analgesic overuse/rebound headache; (3) recommend NSAIDs and triptans as symptomatic medications; and (4) active use of preventive medications when headaches begin to increase in frequency.

• #76 Treatment of chronic daily headache | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1007/s10194-004-0118-1

  Patients with chronic daily headache (CDH) are difficult to treat. A combination of general measures and specific pharmacological treatments is necessary. […] When possible, pharmacological management should be planned on an outpatient basis. The general protocol should include abrupt discontinuation of the offending symptomatic medications, specific treatment for detoxification, daily nonsteroidal anti-inflammatory drugs (NSAIDs) for about 1 month, triptans only for moderate-severe headache, and prophylactic treatment. Either amitriptyline plus propranolol or valproic acid have been classically recommended for transformed migraine prophylaxis. Refractory patients can respond to a combination of a beta-blocker and valproic acid, possibly due to their complementary mechanisms of action. Recently, the new antiepileptic topiramate has been shown to be especially useful in this indication. At least one-third of patients, however, do not improve. Therefore, the best treatment of this incapacitating entity continues to be its prevention. Preventive measures should include: (1) public information concerning the risk of frequent self-treatment for headaches; (2) inform headache patients of the risk of analgesic overuse/rebound headache; (3) recommend NSAIDs and triptans as symptomatic medications; and (4) active use of preventive medications when headaches begin to increase in frequency.

• #77 Treatment of chronic daily headache | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1007/s10194-004-0118-1

  Patients with chronic daily headache (CDH) are difficult to treat. A combination of general measures and specific pharmacological treatments is necessary. […] When possible, pharmacological management should be planned on an outpatient basis. The general protocol should include abrupt discontinuation of the offending symptomatic medications, specific treatment for detoxification, daily nonsteroidal anti-inflammatory drugs (NSAIDs) for about 1 month, triptans only for moderate-severe headache, and prophylactic treatment. Either amitriptyline plus propranolol or valproic acid have been classically recommended for transformed migraine prophylaxis. Refractory patients can respond to a combination of a beta-blocker and valproic acid, possibly due to their complementary mechanisms of action. Recently, the new antiepileptic topiramate has been shown to be especially useful in this indication. At least one-third of patients, however, do not improve. Therefore, the best treatment of this incapacitating entity continues to be its prevention. Preventive measures should include: (1) public information concerning the risk of frequent self-treatment for headaches; (2) inform headache patients of the risk of analgesic overuse/rebound headache; (3) recommend NSAIDs and triptans as symptomatic medications; and (4) active use of preventive medications when headaches begin to increase in frequency.

• #78 Chronic Daily Headache – London Headache Centre

  https://londonheadachecentre.co.uk/heahache-information-for-patients/chronic-daily-headache/

  Chronic migraine may be treated with a wide selection of prophylactic treatments, including tricyclic antidepressants, beta-blockers, anti-epileptics, and Botox. […] Chronic cluster headache may respond to verapamil, topiramate, lithium, methysergide, or melatonin. […] Chronic paroxysmal hemicrania or hemicrania continua should respond to indometacin. […] All chronic trigeminal autonomic cephalgias may respond to occipital nerve stimulation. […] Although CDH is often challenging to deal with, accuracy in diagnosis and perseverance in treatment can lead to significant improvements in virtually all cases.

• #79 Best Chronic Headache Treatment NYC (Midtown, Manhattan) & NJ | Constant Headaches Relief

  https://www.advancedheadachecenter.com/headaches/chronic-headaches

  Consulting with a healthcare provider to develop an individualized treatment plan is essential to control chronic headaches and improve daily functioning. […] Your first step toward a pain-free life and returning to your normal routines is visiting Dr. Hosny at the Advanced Headache Center nearest you. After an accurate diagnosis, you can begin to get immediate chronic headache treatment that’s appropriate for you.

Zobacz więcej