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. […] 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. […] Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache.

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

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

  Chronic daily headache 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.

• #3 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 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.

• #4

  https://headachemedicine.com.br/index.php/hm/article/view/1211

  Chronic daily headache (CDH) has a multifactorial etiology and is defined as a migraine lasting more than 4 hours per day for 15 or more days per month. […] To understand the management and prevention of chronic daily headache. […] The primary management approach is prophylactic medication treatment, where the choice of the agent should be based on the type of CDH, side effects, and comorbidities presented. Examples of medications include antidepressants, antiepileptics, antihypertensives, and anti-serotonergic drugs. Another measure is the implementation of non-pharmacological therapies, such as cognitive-behavioral therapies and healthy lifestyle habits, with special attention to sleep. […] Chronic daily headache is a challenge for medical care in terms of its management and prevention, given the variety of diagnostic alternatives and the diversity of disorders that contribute to the development of this condition.

• #5 Chronic Non-Progressive Headache

  https://mobile.fpnotebook.com/Neuro/Headache/ChrncNnPrgrsvHdch.htm

  Chronic Daily Headache accounts for 3-5% of acute Headache presentations in U.S. […] More common in women (5-9% Prevalence) than men (1-3% Prevalence) […] Almost two thirds of Chronic Daily Headache patients have used Analgesics on 14 or more days per month […] Analgesic overuse is a common contributing factor to Chronic Daily Headache […] Some studies suggest partial Analgesic withdrawal on Headache prophylaxis is effective […] Effective for Migraine Headache and Tension Headache prevention […] Not found to be effective in Headache prophylaxis.

• #6 Management of chronic headache

  https://www.racgp.org.au/afp/2014/march/chronic-headache

  Diagnosis remains the cornerstone of headache management but may also be subject to external factors. […] Researchers define chronic headache on the basis of frequency (15 days per month) and duration (4 hours per headache day) over the preceding 6 months and it may include either TTH or migraine. […] Where headaches occur more frequently than once per fortnight, prophylaxis should be offered and the choice determined by the headache type, as set out within the continuum model. […] TTH is best managed with tricyclic antidepressants (amitriptyline where sleep disturbance is a prominent feature and imipramine where sleep does not pose a problem). […] Pizotifen is the agent of choice for prophylaxis of migraine. […] Agents such as sodium valproate, topiramate and verapamil have been advocated for migraine prophylaxis.

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

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

  Chronic daily headache 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.

• #8 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 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.

• #9 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. […] 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. […] Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache.

• #10 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Preventive therapy for episodic migraines may decrease headache frequency, severity, and prevent progression to chronic migraines. […] Preventive therapy should be considered in patients having four or more headaches a month or at least eight headache days a month, significantly debilitating attacks despite appropriate acute management, difficulty tolerating or having a contraindication to acute therapy, medication overuse headache, patient preference, or the presence of certain migraine subtypes (i.e., hemiplegic migraine; migraine with brainstem aura; migrainous infarction; or frequent, persistent, or uncomfortable aura symptoms). […] Divalproex (Depakote), topiramate (Topamax), metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered as first-line treatment.

• #11 Migraine Prophylaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507873/

  Recurrent migraines can be functionally disabling and can impair quality of life. After treating acute migraines, all migraine patients should be evaluated for preventive therapy. Preventive therapy aims to decrease the frequency, severity, and duration of migraine attacks. Furthermore, preventative therapy can increase responsiveness to acute migraine therapy and improve the quality of life. Prophylactic treatment is not curative, and most patients will still need abortive medications for acute migraine. Before starting prophylactic medications, it is imperative to evaluate if patients are using proper and adequate abortive therapies. Overuse of abortive medications can cause rebound headaches. […] Prophylactic migraine treatment should be considered in patients with more than three monthly episodes or at least eight headache days in one month. Patients with severe debilitating headaches despite appropriate acute treatment or those who are intolerant or have contraindications to acute therapy. Prophylaxis should also be considered in patients with medication overuse headaches, certain migraine subtypes like hemiplegic migraine, basilar migraine, migraine with prolonged aura, or if the patient prefers. […] Prophylactic therapy may decrease the frequency, severity, and duration of migraine attacks, increase responsiveness to acute migraine therapy and improve quality of life. […] Prophylaxis for episodic migraine may reduce headache severity and frequency and prevent progression to chronic migraine.

• #12 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Preventive therapy for episodic migraines may decrease headache frequency, severity, and prevent progression to chronic migraines. […] Preventive therapy should be considered in patients having four or more headaches a month or at least eight headache days a month, significantly debilitating attacks despite appropriate acute management, difficulty tolerating or having a contraindication to acute therapy, medication overuse headache, patient preference, or the presence of certain migraine subtypes (i.e., hemiplegic migraine; migraine with brainstem aura; migrainous infarction; or frequent, persistent, or uncomfortable aura symptoms). […] Divalproex (Depakote), topiramate (Topamax), metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered as first-line treatment.

• #13 Migraine Prophylaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507873/

  Recurrent migraines can be functionally disabling and can impair quality of life. After treating acute migraines, all migraine patients should be evaluated for preventive therapy. Preventive therapy aims to decrease the frequency, severity, and duration of migraine attacks. Furthermore, preventative therapy can increase responsiveness to acute migraine therapy and improve the quality of life. Prophylactic treatment is not curative, and most patients will still need abortive medications for acute migraine. Before starting prophylactic medications, it is imperative to evaluate if patients are using proper and adequate abortive therapies. Overuse of abortive medications can cause rebound headaches. […] Prophylactic migraine treatment should be considered in patients with more than three monthly episodes or at least eight headache days in one month. Patients with severe debilitating headaches despite appropriate acute treatment or those who are intolerant or have contraindications to acute therapy. Prophylaxis should also be considered in patients with medication overuse headaches, certain migraine subtypes like hemiplegic migraine, basilar migraine, migraine with prolonged aura, or if the patient prefers. […] Prophylactic therapy may decrease the frequency, severity, and duration of migraine attacks, increase responsiveness to acute migraine therapy and improve quality of life. […] Prophylaxis for episodic migraine may reduce headache severity and frequency and prevent progression to chronic migraine.

• #14 Migraine Prophylaxis in Adults | Doctor

  https://patient.info/doctor/migraine-prophylaxis-in-adults

  Migraine prophylaxis can reduce the frequency and severity of migraine, but is under-used by people who might benefit from it. […] The aim of preventative treatment is to reduce the frequency, severity, and duration of migraine attacks, and avoid medication-induced headache. […] British Association for the Study of Headache (BASH) guidelines state that prophylaxis should be used when symptoms are inadequately controlled with acute prescriptions, or the frequency of attacks is leading to overuse of acute medicines. […] The National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summary (CKS), synthesising information from different guidelines, suggests prophylaxis where: Migraine attacks are having a significant impact on quality of life and daily function – eg, they occur frequently (more than once a week on average) or are prolonged and severe despite optimal acute treatment.

• #15 Migraine Prophylaxis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507873/

  Recurrent migraines can be functionally disabling and can impair quality of life. After treating acute migraines, all migraine patients should be evaluated for preventive therapy. Preventive therapy aims to decrease the frequency, severity, and duration of migraine attacks. Furthermore, preventative therapy can increase responsiveness to acute migraine therapy and improve the quality of life. Prophylactic treatment is not curative, and most patients will still need abortive medications for acute migraine. Before starting prophylactic medications, it is imperative to evaluate if patients are using proper and adequate abortive therapies. Overuse of abortive medications can cause rebound headaches. […] Prophylactic migraine treatment should be considered in patients with more than three monthly episodes or at least eight headache days in one month. Patients with severe debilitating headaches despite appropriate acute treatment or those who are intolerant or have contraindications to acute therapy. Prophylaxis should also be considered in patients with medication overuse headaches, certain migraine subtypes like hemiplegic migraine, basilar migraine, migraine with prolonged aura, or if the patient prefers. […] Prophylactic therapy may decrease the frequency, severity, and duration of migraine attacks, increase responsiveness to acute migraine therapy and improve quality of life. […] Prophylaxis for episodic migraine may reduce headache severity and frequency and prevent progression to chronic migraine.

• #16 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. […] 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.

• #17 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. […] 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. […] Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache.

• #18 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. […] 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.

• #19 Management of chronic headache

  https://www.racgp.org.au/afp/2014/march/chronic-headache

  Diagnosis remains the cornerstone of headache management but may also be subject to external factors. […] Researchers define chronic headache on the basis of frequency (15 days per month) and duration (4 hours per headache day) over the preceding 6 months and it may include either TTH or migraine. […] Where headaches occur more frequently than once per fortnight, prophylaxis should be offered and the choice determined by the headache type, as set out within the continuum model. […] TTH is best managed with tricyclic antidepressants (amitriptyline where sleep disturbance is a prominent feature and imipramine where sleep does not pose a problem). […] Pizotifen is the agent of choice for prophylaxis of migraine. […] Agents such as sodium valproate, topiramate and verapamil have been advocated for migraine prophylaxis.

• #20 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. […] 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. […] Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache.

• #21 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. […] 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. […] 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. Any headache that does occur whilst taking preventative medication may also be eased better than previously by a painkiller.

• #22 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. […] 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.

• #23 Management of chronic headache

  https://www.racgp.org.au/afp/2014/march/chronic-headache

  Diagnosis remains the cornerstone of headache management but may also be subject to external factors. […] Researchers define chronic headache on the basis of frequency (15 days per month) and duration (4 hours per headache day) over the preceding 6 months and it may include either TTH or migraine. […] Where headaches occur more frequently than once per fortnight, prophylaxis should be offered and the choice determined by the headache type, as set out within the continuum model. […] TTH is best managed with tricyclic antidepressants (amitriptyline where sleep disturbance is a prominent feature and imipramine where sleep does not pose a problem). […] Pizotifen is the agent of choice for prophylaxis of migraine. […] Agents such as sodium valproate, topiramate and verapamil have been advocated for migraine prophylaxis.

• #24 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. […] 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.

• #25 How should we treat chronic daily headache when conservative measures fail? | MDedge Family Medicine

  https://www.mdedge9-ma1.mdedge.com/familymedicine/article/60268/neurology/how-should-we-treat-chronic-daily-headache-when-conservative

  Amitriptyline is the best-supported option for the treatment of chronic daily headaches for those patients who have not been treated by conservative measures (strength of recommendation [SOR]: A, based on a meta-analysis of randomized controlled trials [RCTs]).1 […] For patients who overuse symptomatic headache medications, medication withdrawal is effective (SOR: B, based on a systematic review of cohort and case-control studies).2 […] Other therapies for treating chronic daily headache include the skeletal muscle relaxant tizanidine (Zanaflex), which was studied in an industry-sponsored, double-blind, placebo-controlled trial of 92 patients. […] Stress management, acupuncture, botulinum toxin, behavioral therapy including relaxation therapy, biofeedback, and even Internet-based self-help have all been studied, but most of these therapies do not have significant evidence-based support. […] Preventive headache medications do not work if analgesics are being overused. […] Once a diagnosis is made, detoxification needs to be discussed with the patient.

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

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

  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. […] All patients with chronic daily headache should be counseled about medication overuse, which can complicate the course of the headache. […] 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.

• #27 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. […] Before trying complementary or alternative therapy, discuss the risks and benefits with your doctor.

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

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

  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. […] All patients with chronic daily headache should be counseled about medication overuse, which can complicate the course of the headache. […] 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.

• #29 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

  Gabapentin (for example, sold as Pendine and Gabahexal) is another anti-seizure medicine which has been demonstrated effective in reducing the frequency of chronic migraine. It has also been shown to reduce migraine-associated disability. […] Tizanidine is a muscle-relaxing medicine which has proven effective in reducing the average number of headache days for individuals who experience chronic migraine, as well as reducing the intensity and duration of headaches when they do occur. […] Sodium valproate, (for example sold as Valpro and Epilim) a sodium-blocking medication commonly used as anti-seizure treatment has been shown to reduce the frequency and severity of chronic migraine pain. […] Botulinum toxin A has demonstrated efficacy in the prophylactic treatment of chronic migraine. In one study, individuals who received botulinum toxin A injections experienced significantly less frequent headaches compared to those receiving placebo injection. However, the reduced frequency of headache did not result in a similar reduction in use of acute medications.

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

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

  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. […] All patients with chronic daily headache should be counseled about medication overuse, which can complicate the course of the headache. […] 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.

• #31 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 prevention […] 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. Most of the medications used in migraine prophylaxis (e.g. ?-blockers, anticonvulsants, and tricyclic antidepressants) have not been evaluated for efficacy in treating chronic migraine, however they are commonly used and considered effective in clinical practice. […] Topiramate (for example, sold as Topamax) is an anti-seizure medication, also used in the treatment of migraine. It is the medicine with the best evidence for effectiveness in preventing chronic migraine. Using this medicine has been shown to reduce the frequency of chronic migraine, however it is not known whether or not individuals who use topiramate also reduce the quantity of medicine used to treat acute migraine attacks.

• #32 The effect of sodium valproate on chronic daily headache and its subgroups | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1007/s10194-008-0002-5

  The objective of the study was to assess the efficacy and tolerability of sodium valproate (VPA) on chronic daily headache (CDH) in a prospective, double-blind, randomized, placebo-controlled trial. […] VPA is effective in the prophylactic treatment of CDH by reducing MaxVAS levels and PF. It was more effective in CM than in CTTH. […] The data demonstrate that VPA reduces pain level and PF in patients with CDH when compared with placebo. Furthermore, among the subgroups of CDH, it was more effective in CM than in CTTH. […] In summary, we report a randomized, placebo-controlled trial demonstrating that VPA is superior to placebo in prophylactic treatment of CDH. The clinical beneficial effect of VPA in CM was more than CTTH. VPA appears to be a worthwhile addition to the prophylactic treatment of CDH as a well tolerated drug.

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

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

  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. […] All patients with chronic daily headache should be counseled about medication overuse, which can complicate the course of the headache. […] 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.

• #34 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. […] Before trying complementary or alternative therapy, discuss the risks and benefits with your doctor.

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

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

  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. […] All patients with chronic daily headache should be counseled about medication overuse, which can complicate the course of the headache. […] 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.

• #36 Migraine Prophylaxis in Adults | Doctor

  https://patient.info/doctor/migraine-prophylaxis-in-adults

  Consider non-pharmacological therapies as an adjunct or alternative to pharmacological therapy – for example: Biofeedback, relaxation technique, and cognitive behavioural therapies have shown efficacy in the prevention of episodic migraine but data regarding efficacy in chronic migraine are limited. […] Propranolol hydrochloride (80-160 mg daily, in divided doses) is recommended as first-line preventative treatment in patients with episodic or chronic migraine. […] Topiramate can be given if a beta-blocker is unsuitable. […] Amitriptyline hydrochloride is effective (25-75 mg at night) for migraine prophylaxis and should be considered for patients with episodic or chronic migraine. […] Botulinum toxin type A is recommended for prophylaxis of chronic migraine where medication overuse has been addressed and where three or more oral prophylactic treatments have failed.

• #37 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Preventive therapy for episodic migraines may decrease headache frequency, severity, and prevent progression to chronic migraines. […] Preventive therapy should be considered in patients having four or more headaches a month or at least eight headache days a month, significantly debilitating attacks despite appropriate acute management, difficulty tolerating or having a contraindication to acute therapy, medication overuse headache, patient preference, or the presence of certain migraine subtypes (i.e., hemiplegic migraine; migraine with brainstem aura; migrainous infarction; or frequent, persistent, or uncomfortable aura symptoms). […] Divalproex (Depakote), topiramate (Topamax), metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered as first-line treatment.

• #38

  https://bpac.org.nz/2017/headache.aspx

  Beta-blockers are the first-line medicines for migraine prophylaxis in patients without asthma or peripheral vascular disease. […] Amitriptyline (unapproved indication) is also a first-line prophylactic medicine for patients with migraine, often for those with co-morbid chronic pain, disturbed sleep or depression. […] Topiramate and sodium valproate (unapproved indication) are effective in the prophylaxis of migraine, however, they are second-line medicines due to the risk of serious adverse effects.

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

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

  Several prophylactic drug therapies have been studied for the treatment of chronic daily headache. […] Other pharmacologic options include tizanidine (Zanaflex), certain anticonvulsants, propranolol, and onabotulinumtoxinA (Botox). […] Education about headache from medication overuse is essential. […] Although many experts recommend a complete withdrawal of acute medications in patients with headache from medication overuse, one randomized controlled trial suggests that patients can benefit from prophylactic treatment without complete withdrawal of abortive therapy.

• #40 Chronic daily headache prophylaxis with tizanidine: a double-blind, placebo-controlled, multicenter outcome study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/12167135/

  Objective: To assess the efficacy of tizanidine hydrochloride versus placebo as adjunctive prophylactic therapy for chronic daily headache (chronic migraine, migrainous headache, or tension-type headache). […] The results support tizanidine as an effective prophylactic adjunct for chronic daily headache, including migraine, migrainous headache, and tension-type headache. These results also suggest the possible importance of an alpha2-adrenergic mechanism underlying the pathophysiology of this spectrum of headache disorders.

• #41 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

  Gabapentin (for example, sold as Pendine and Gabahexal) is another anti-seizure medicine which has been demonstrated effective in reducing the frequency of chronic migraine. It has also been shown to reduce migraine-associated disability. […] Tizanidine is a muscle-relaxing medicine which has proven effective in reducing the average number of headache days for individuals who experience chronic migraine, as well as reducing the intensity and duration of headaches when they do occur. […] Sodium valproate, (for example sold as Valpro and Epilim) a sodium-blocking medication commonly used as anti-seizure treatment has been shown to reduce the frequency and severity of chronic migraine pain. […] Botulinum toxin A has demonstrated efficacy in the prophylactic treatment of chronic migraine. In one study, individuals who received botulinum toxin A injections experienced significantly less frequent headaches compared to those receiving placebo injection. However, the reduced frequency of headache did not result in a similar reduction in use of acute medications.

• #42 Management of chronic headache

  https://www.racgp.org.au/afp/2014/march/chronic-headache

  Diagnosis remains the cornerstone of headache management but may also be subject to external factors. […] Researchers define chronic headache on the basis of frequency (15 days per month) and duration (4 hours per headache day) over the preceding 6 months and it may include either TTH or migraine. […] Where headaches occur more frequently than once per fortnight, prophylaxis should be offered and the choice determined by the headache type, as set out within the continuum model. […] TTH is best managed with tricyclic antidepressants (amitriptyline where sleep disturbance is a prominent feature and imipramine where sleep does not pose a problem). […] Pizotifen is the agent of choice for prophylaxis of migraine. […] Agents such as sodium valproate, topiramate and verapamil have been advocated for migraine prophylaxis.

• #43

  https://bpac.org.nz/2017/headache.aspx

  Beta-blockers or amitriptyline may be considered for prophylaxis in patients with frequent migraine, despite optimal acute management. […] Prophylactic treatment with naproxen or a tricyclic antidepressant may be considered for patients with recurrent tension-type headaches. […] For patients with tension-type headache on 15 days or more a month, i.e. chronic tension-type headache, a three week course of naproxen, 250-500 mg, twice daily, may be considered. […] A tricyclic antidepressant (TCA) may also be considered for the prophylaxis of recurrent tension-type headache (unapproved indication). […] Migraine prophylaxis should be considered for patients when they find acute treatment to be inadequate, they have more than three attacks per month, despite optimal management, or they are at risk of medicine overuse headache.

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

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

  Monoclonal antibodies […] This new class of migraine-prevention therapies target the calcitonin gene-related peptide (CGRP) pathway, a protein linked to migraine symptoms. […] Providers suggest taking acute headache treatments no more than 10 days each month, because overindulging in either over-the-counter drugs or triptans can cause headaches. Medication overuse underlies many cases of episodic migraines that become chronic. […] „For people finding they need to take a lot of breakthrough medications, gepants would be a good option because they’re less likely to develop rebound headaches,” she says. […] 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. […] Lifestyle changes are also key, Dr. Shadbehr says. Getting enough sleep, hydrating and limiting caffeine can all ease headache symptoms. Keeping a migraine diary can also help you and your provider identify your patterns and personal food triggers. […] There are individualized treatment plans available to help alleviate chronic headaches and improve your quality of life.

• #45 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Behavioral treatments, such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy, are effective options for migraine prevention. […] Once the need for prophylactic treatment is established, adhering to the following consensus-based principles of care may improve the success of preventive therapy. […] Start therapy with medications that have the highest level of evidence-based effectiveness. […] Allow an adequate trial for each treatment. The patient may see improvement in six to eight weeks, but it may take up to six months for full effect. […] OnabotulinumtoxinA (Botox) is ineffective and should not be offered for preventing episodic migraine. However, there is evidence supporting the use of onabotulinumtoxinA in the prevention of chronic migraines.

• #46 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. […] Before trying complementary or alternative therapy, discuss the risks and benefits with your doctor.

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

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

  Monoclonal antibodies […] This new class of migraine-prevention therapies target the calcitonin gene-related peptide (CGRP) pathway, a protein linked to migraine symptoms. […] Providers suggest taking acute headache treatments no more than 10 days each month, because overindulging in either over-the-counter drugs or triptans can cause headaches. Medication overuse underlies many cases of episodic migraines that become chronic. […] „For people finding they need to take a lot of breakthrough medications, gepants would be a good option because they’re less likely to develop rebound headaches,” she says. […] 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. […] Lifestyle changes are also key, Dr. Shadbehr says. Getting enough sleep, hydrating and limiting caffeine can all ease headache symptoms. Keeping a migraine diary can also help you and your provider identify your patterns and personal food triggers. […] There are individualized treatment plans available to help alleviate chronic headaches and improve your quality of life.

• #48 Tips for Migraine and Headache Prevention

  https://www.everydayhealth.com/headache-migraine/headache-prevention.aspx

  Erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) are once-monthly drugs that people inject at home to help prevent migraine. […] Botox has also proven to be an effective migraine preventive and is FDA-approved for people with chronic migraine, which is defined as 15 or more headache days per month. […] Magnesium supplements can also be taken daily as prevention, says Nada Hindiyeh, MD, a neurologist and headache specialist at the Metrodora Institute in West Valley City, Utah. […] Hydration is one of the other healthy habits where consistency can make a big difference in migraine prevention, says Strauss. […] Exercise is one of the lifestyle modifications that can make a real difference in preventing migraine, says Hindiyeh. […] Regular aerobic exercise can work as a preventive medication all on its own, and there are also some studies to suggest that yoga and HIIT (high-intensity interval training) can be helpful as well, she says. […] Its a good practice for people with headaches or migraine to have breakfast, lunch, and dinner with some snacks throughout the day, she adds. […] Its a good idea to assess your situation, including where and how you sit most of the day, says Strauss.

• #49 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Erenumab (Aimovig) was approved by the U.S. Food and Drug Administration in May 2018 for migraine prevention. […] Petasites, an extract of the butterbur plant, is effective for the prophylactic treatment of migraines in dosages of 50 to 75 mg twice a day. […] A U.S. Headache Consortium meta-analysis concluded that relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy may be considered as treatment options for the prevention of migraine.

• #50 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Behavioral treatments, such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy, are effective options for migraine prevention. […] Once the need for prophylactic treatment is established, adhering to the following consensus-based principles of care may improve the success of preventive therapy. […] Start therapy with medications that have the highest level of evidence-based effectiveness. […] Allow an adequate trial for each treatment. The patient may see improvement in six to eight weeks, but it may take up to six months for full effect. […] OnabotulinumtoxinA (Botox) is ineffective and should not be offered for preventing episodic migraine. However, there is evidence supporting the use of onabotulinumtoxinA in the prevention of chronic migraines.

• #51 Preventive medicines for migraine – The Migraine TrustVisualV1 – SearchVisualV1 – CrossVisualV1 – Home VisualV1 – CrossVisualV1 – DownloadVisualV1 – Arrow

  https://migrainetrust.org/live-with-migraine/healthcare/treatments/preventive-medicines/

  Preventive medicines for migraine are medicines you take to prevent migraine attacks. There are several different types. […] Preventive medicines are also known as prophylactics. You take them on a regular basis (sometimes every day) to help stop migraine attacks developing. […] Preventive medicines aim to reduce how many migraine attacks you get and how severe they are. […] Not everyone needs to take preventive migraine medicines. […] Talk to your GP to discuss whether preventive medicines would be a good option for you. […] There are several different types of medicine that can be used to prevent migraine attacks. […] Your doctor will assess several things when deciding which medicine to prescribe. […] If your medication is working well, you should be able to continue taking it for at least six months to a year. […] If your preventive migraine medication is not helping, talk to your doctor.

• #52 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. […] Before trying complementary or alternative therapy, discuss the risks and benefits with your doctor.

• #53 Migraine treatment and prevention | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine-treatment-and-prevention/

  Preventing migraine is important to maintain a generally healthy lifestyle, including regular exercise, sleep and meals, ensuring you stay well hydrated, limiting your intake of caffeine, and limiting your intake of alcohol. […] One of the best ways of preventing migraine is recognising the things that trigger an attack and trying to avoid them. […] Medication is available to help prevent migraine attacks. Preventive medication is normally used if your migraine headaches remain frequent (more than 1 migraine attack per week) following a period of avoiding possible triggers. […] Preventive medication is not a cure for migraine attacks. The aim is to reduce how severe and often migraine attacks occur. A good response to preventive medication would be a 30% to 50% reduction in frequency and severity. […] You might be offered advanced therapies for migraine that can only be prescribed by a neurologist. […] If other treatments aren’t controlling your migraine headaches, you might be referred to a specialist migraine clinic for further treatment.

• #54 Migraine/Chronic Headache – RefHelp

  https://apps.nhslothian.scot/refhelp/guidelines/neurology/headache/migraine-chronic-headache/

  These recommendations apply to episodic and chronic migraine. Most patients with chronic daily headache referred to neurology have underlying chronic migraine; which often coexists with medication overuse, sleep disturbance and fatigue. […] Patients who have not responded to at least three first line preventive treatment may be started on gepants (Atogepant/Rimegepant) prior to referral to secondary care. […] Prophylaxis should be considered when patients are overusing acute treatments, or headaches interfere with social or occupational functioning. Patients must be counselled that prophylaxis aims to reduce the frequency and/or severity of attacks, not abolish them completely; a reduction of 30% in either frequency or severity is a positive response. […] Gepants: can be prescribed for prevention of episodic or chronic migraine in primary care if patients have more than 10 moderate/severe migraine days per month and have not responded to three preventative agents. […] Botox and CGRP medications (e.g. Erenumab, Fremanezumab, Galcanezumab) are available for eligible patients on prescription or recommendation from the Headache clinics run in Neurology.

• #55 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. […] 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. […] Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache.

• #56 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. […] Emerging evidence suggests that peripheral nerve stimulation in the occipital region can reduce pain, disability, and number of headache days in patients with chronic migraine for at least one year. […] An initial trial of discontinuing acute medications used for headaches may be warranted to help determine whether medication overuse has a role.

• #57 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. […] 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. […] Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache.

• #58 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. […] Emerging evidence suggests that peripheral nerve stimulation in the occipital region can reduce pain, disability, and number of headache days in patients with chronic migraine for at least one year. […] An initial trial of discontinuing acute medications used for headaches may be warranted to help determine whether medication overuse has a role.

• #59 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Behavioral treatments, such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy, are effective options for migraine prevention. […] Once the need for prophylactic treatment is established, adhering to the following consensus-based principles of care may improve the success of preventive therapy. […] Start therapy with medications that have the highest level of evidence-based effectiveness. […] Allow an adequate trial for each treatment. The patient may see improvement in six to eight weeks, but it may take up to six months for full effect. […] OnabotulinumtoxinA (Botox) is ineffective and should not be offered for preventing episodic migraine. However, there is evidence supporting the use of onabotulinumtoxinA in the prevention of chronic migraines.

• #60 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. […] 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. […] Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache.

• #61 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. […] Emerging evidence suggests that peripheral nerve stimulation in the occipital region can reduce pain, disability, and number of headache days in patients with chronic migraine for at least one year. […] An initial trial of discontinuing acute medications used for headaches may be warranted to help determine whether medication overuse has a role.

• #62 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Erenumab (Aimovig) was approved by the U.S. Food and Drug Administration in May 2018 for migraine prevention. […] Petasites, an extract of the butterbur plant, is effective for the prophylactic treatment of migraines in dosages of 50 to 75 mg twice a day. […] A U.S. Headache Consortium meta-analysis concluded that relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy may be considered as treatment options for the prevention of migraine.

• #63 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Behavioral treatments, such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy, are effective options for migraine prevention. […] Once the need for prophylactic treatment is established, adhering to the following consensus-based principles of care may improve the success of preventive therapy. […] Start therapy with medications that have the highest level of evidence-based effectiveness. […] Allow an adequate trial for each treatment. The patient may see improvement in six to eight weeks, but it may take up to six months for full effect. […] OnabotulinumtoxinA (Botox) is ineffective and should not be offered for preventing episodic migraine. However, there is evidence supporting the use of onabotulinumtoxinA in the prevention of chronic migraines.

• #64 Migraine treatment and prevention | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine-treatment-and-prevention/

  Preventing migraine is important to maintain a generally healthy lifestyle, including regular exercise, sleep and meals, ensuring you stay well hydrated, limiting your intake of caffeine, and limiting your intake of alcohol. […] One of the best ways of preventing migraine is recognising the things that trigger an attack and trying to avoid them. […] Medication is available to help prevent migraine attacks. Preventive medication is normally used if your migraine headaches remain frequent (more than 1 migraine attack per week) following a period of avoiding possible triggers. […] Preventive medication is not a cure for migraine attacks. The aim is to reduce how severe and often migraine attacks occur. A good response to preventive medication would be a 30% to 50% reduction in frequency and severity. […] You might be offered advanced therapies for migraine that can only be prescribed by a neurologist. […] If other treatments aren’t controlling your migraine headaches, you might be referred to a specialist migraine clinic for further treatment.

• #65 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. […] 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. […] Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache.

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

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

  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. […] All patients with chronic daily headache should be counseled about medication overuse, which can complicate the course of the headache. […] 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.

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

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

  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. […] All patients with chronic daily headache should be counseled about medication overuse, which can complicate the course of the headache. […] 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.

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

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

  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.

• #69 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. […] 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. […] Amitriptyline may reduce headache duration and severity compared with placebo for chronic tension-type headache.

• #70 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. […] Emerging evidence suggests that peripheral nerve stimulation in the occipital region can reduce pain, disability, and number of headache days in patients with chronic migraine for at least one year. […] An initial trial of discontinuing acute medications used for headaches may be warranted to help determine whether medication overuse has a role.

• #71 Chronic daily headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891

  Taking care of yourself might help ease chronic daily headaches. […] Avoid headache triggers. Keeping a headache diary can help you determine what triggers your headaches so that you can avoid the triggers. Include details about every headache, such as when it started, what you were doing at the time and how long it lasted. […] Avoid medication overuse. Taking headache medications, including over-the-counter medications, more than twice a week can increase the severity and frequency of your headaches. Consult your doctor about how to wean yourself off the medication because there can be serious side effects if done improperly. […] Get enough sleep. The average adult needs seven to eight hours of sleep a night. It’s best to go to bed and wake up at the same time every day. Talk to your doctor if you have sleep disturbances, such as snoring.

• #72 Chronic daily headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891

  Don’t skip meals. Eat healthy meals at about the same times daily. Avoid food or drinks, such as those containing caffeine, that seem to trigger headaches. Lose weight if you’re obese. […] Exercise regularly. Regular aerobic physical activity can improve your physical and mental well-being and reduce stress. With your doctor’s OK, choose activities you enjoy such as walking, swimming or cycling. To avoid injury, start slowly. […] Reduce stress. Stress is a common trigger of chronic headaches. Get organized. Simplify your schedule. Plan ahead. Stay positive. Try stress-reduction techniques, such as yoga, tai chi or meditation. […] Reduce caffeine. While some headache medications include caffeine because it can be beneficial in reducing headache pain, it can also aggravate headaches. Try to minimize or eliminate caffeine from your diet.

• #73 Chronic daily headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891

  Taking care of yourself might help ease chronic daily headaches. […] Avoid headache triggers. Keeping a headache diary can help you determine what triggers your headaches so that you can avoid the triggers. Include details about every headache, such as when it started, what you were doing at the time and how long it lasted. […] Avoid medication overuse. Taking headache medications, including over-the-counter medications, more than twice a week can increase the severity and frequency of your headaches. Consult your doctor about how to wean yourself off the medication because there can be serious side effects if done improperly. […] Get enough sleep. The average adult needs seven to eight hours of sleep a night. It’s best to go to bed and wake up at the same time every day. Talk to your doctor if you have sleep disturbances, such as snoring.

• #74 Chronic daily headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891

  Taking care of yourself might help ease chronic daily headaches. […] Avoid headache triggers. Keeping a headache diary can help you determine what triggers your headaches so that you can avoid the triggers. Include details about every headache, such as when it started, what you were doing at the time and how long it lasted. […] Avoid medication overuse. Taking headache medications, including over-the-counter medications, more than twice a week can increase the severity and frequency of your headaches. Consult your doctor about how to wean yourself off the medication because there can be serious side effects if done improperly. […] Get enough sleep. The average adult needs seven to eight hours of sleep a night. It’s best to go to bed and wake up at the same time every day. Talk to your doctor if you have sleep disturbances, such as snoring.

• #75 Mayo Clinic Health Library – Chronic daily headaches | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20370872

  Taking care of yourself might help ease chronic daily headaches. […] Avoid headache triggers. Keeping a headache diary can help you determine what triggers your headaches so that you can avoid the triggers. […] Avoid medication overuse. Taking headache medications, including over-the-counter medications, more than twice a week can increase the severity and frequency of your headaches. […] Get enough sleep. The average adult needs seven to eight hours of sleep a night. […] Don’t skip meals. Eat healthy meals at about the same times daily. […] Exercise regularly. Regular aerobic physical activity can improve your physical and mental well-being and reduce stress. […] Reduce stress. Stress is a common trigger of chronic headaches. […] Reduce caffeine. While some headache medications include caffeine because it can be beneficial in reducing headache pain, it can also aggravate headaches.

• #76 Chronic daily headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891

  Taking care of yourself might help ease chronic daily headaches. […] Avoid headache triggers. Keeping a headache diary can help you determine what triggers your headaches so that you can avoid the triggers. Include details about every headache, such as when it started, what you were doing at the time and how long it lasted. […] Avoid medication overuse. Taking headache medications, including over-the-counter medications, more than twice a week can increase the severity and frequency of your headaches. Consult your doctor about how to wean yourself off the medication because there can be serious side effects if done improperly. […] Get enough sleep. The average adult needs seven to eight hours of sleep a night. It’s best to go to bed and wake up at the same time every day. Talk to your doctor if you have sleep disturbances, such as snoring.

• #77 Chronic daily headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891

  Don’t skip meals. Eat healthy meals at about the same times daily. Avoid food or drinks, such as those containing caffeine, that seem to trigger headaches. Lose weight if you’re obese. […] Exercise regularly. Regular aerobic physical activity can improve your physical and mental well-being and reduce stress. With your doctor’s OK, choose activities you enjoy such as walking, swimming or cycling. To avoid injury, start slowly. […] Reduce stress. Stress is a common trigger of chronic headaches. Get organized. Simplify your schedule. Plan ahead. Stay positive. Try stress-reduction techniques, such as yoga, tai chi or meditation. […] Reduce caffeine. While some headache medications include caffeine because it can be beneficial in reducing headache pain, it can also aggravate headaches. Try to minimize or eliminate caffeine from your diet.

• #78 Chronic daily headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891

  Don’t skip meals. Eat healthy meals at about the same times daily. Avoid food or drinks, such as those containing caffeine, that seem to trigger headaches. Lose weight if you’re obese. […] Exercise regularly. Regular aerobic physical activity can improve your physical and mental well-being and reduce stress. With your doctor’s OK, choose activities you enjoy such as walking, swimming or cycling. To avoid injury, start slowly. […] Reduce stress. Stress is a common trigger of chronic headaches. Get organized. Simplify your schedule. Plan ahead. Stay positive. Try stress-reduction techniques, such as yoga, tai chi or meditation. […] Reduce caffeine. While some headache medications include caffeine because it can be beneficial in reducing headache pain, it can also aggravate headaches. Try to minimize or eliminate caffeine from your diet.

• #79 Tips for Migraine and Headache Prevention

  https://www.everydayhealth.com/headache-migraine/headache-prevention.aspx

  Erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) are once-monthly drugs that people inject at home to help prevent migraine. […] Botox has also proven to be an effective migraine preventive and is FDA-approved for people with chronic migraine, which is defined as 15 or more headache days per month. […] Magnesium supplements can also be taken daily as prevention, says Nada Hindiyeh, MD, a neurologist and headache specialist at the Metrodora Institute in West Valley City, Utah. […] Hydration is one of the other healthy habits where consistency can make a big difference in migraine prevention, says Strauss. […] Exercise is one of the lifestyle modifications that can make a real difference in preventing migraine, says Hindiyeh. […] Regular aerobic exercise can work as a preventive medication all on its own, and there are also some studies to suggest that yoga and HIIT (high-intensity interval training) can be helpful as well, she says. […] Its a good practice for people with headaches or migraine to have breakfast, lunch, and dinner with some snacks throughout the day, she adds. […] Its a good idea to assess your situation, including where and how you sit most of the day, says Strauss.

• #80 Chronic daily headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891

  Don’t skip meals. Eat healthy meals at about the same times daily. Avoid food or drinks, such as those containing caffeine, that seem to trigger headaches. Lose weight if you’re obese. […] Exercise regularly. Regular aerobic physical activity can improve your physical and mental well-being and reduce stress. With your doctor’s OK, choose activities you enjoy such as walking, swimming or cycling. To avoid injury, start slowly. […] Reduce stress. Stress is a common trigger of chronic headaches. Get organized. Simplify your schedule. Plan ahead. Stay positive. Try stress-reduction techniques, such as yoga, tai chi or meditation. […] Reduce caffeine. While some headache medications include caffeine because it can be beneficial in reducing headache pain, it can also aggravate headaches. Try to minimize or eliminate caffeine from your diet.

• #81 Chronic daily headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891

  Don’t skip meals. Eat healthy meals at about the same times daily. Avoid food or drinks, such as those containing caffeine, that seem to trigger headaches. Lose weight if you’re obese. […] Exercise regularly. Regular aerobic physical activity can improve your physical and mental well-being and reduce stress. With your doctor’s OK, choose activities you enjoy such as walking, swimming or cycling. To avoid injury, start slowly. […] Reduce stress. Stress is a common trigger of chronic headaches. Get organized. Simplify your schedule. Plan ahead. Stay positive. Try stress-reduction techniques, such as yoga, tai chi or meditation. […] Reduce caffeine. While some headache medications include caffeine because it can be beneficial in reducing headache pain, it can also aggravate headaches. Try to minimize or eliminate caffeine from your diet.

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

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

  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. […] All patients with chronic daily headache should be counseled about medication overuse, which can complicate the course of the headache. […] 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.

• #83 Migraine Headache Prophylaxis | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0101/p17.html

  Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and headache-related distress. Preventive therapy may also improve quality of life and prevent the progression to chronic migraines. Some indications for preventive therapy include four or more headaches a month, eight or more headache days a month, debilitating headaches, and medication-overuse headaches. […] Identifying and managing environmental, dietary, and behavioral triggers are useful strategies for preventing migraines. First-line medications established as effective based on clinical evidence include divalproex, topiramate, metoprolol, propranolol, and timolol.

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

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

  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.

• #85 Chronic Non-Progressive Headache

  https://mobile.fpnotebook.com/Neuro/Headache/ChrncNnPrgrsvHdch.htm

  Chronic Daily Headache accounts for 3-5% of acute Headache presentations in U.S. […] More common in women (5-9% Prevalence) than men (1-3% Prevalence) […] Almost two thirds of Chronic Daily Headache patients have used Analgesics on 14 or more days per month […] Analgesic overuse is a common contributing factor to Chronic Daily Headache […] Some studies suggest partial Analgesic withdrawal on Headache prophylaxis is effective […] Effective for Migraine Headache and Tension Headache prevention […] Not found to be effective in Headache prophylaxis.

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

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

  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.

• #87 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.

• #88 Chronic daily headache |

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

  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. […] 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. […] Early prophylaxis, which may involve medication, behavioural or natural therapy components, should be instituted to reduce the number of acute attacks requiring medication and reduce overall medication use.

• #89 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

  Medication overuse headache […] Preventing medication overuse is the primary measure for preventing medication overuse headache, the most common type of daily headache. Be sure to obtain advice from your doctor regarding the dangers of medication overuse and the potential for chronic migraine to develop. Monitor your headaches and medication use by recording these in a diary, so you have an accurate record of how much medication you use. In Australia, codeine preparations are most commonly implicated in medication overuse headaches, so monitoring medication use is particularly important if your medicine contains codeine. Preparations with up to 12.5 mg of codeine are available over the counter at pharmacies and up to 30 mg per tablet preparations may be prescribed for headache. If you are using a codeine-containing medicine and notice it is becoming less effective, talk to your doctor. Do not increase the dose or change medicines without medical advice and avoid opioid containing medications unless advised by your doctor to use these. Codeine and opioid withdrawal is particularly challenging. Triptans and ergotamine are also commonly involved in medication overuse headaches. In order to prevent medication overuse, these medications should be used infrequently, if at all. The following maximum doses are recommended:

• #90 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

  Triptans 12 doses per week; […] Codeine once a month or preferably not at all; […] Ergot alkaloids never; […] Injected narcotics once every 2 months. […] Medications containing caffeine, opioids or tranquilisers should be avoided. Early prophylaxis, which may involve medication, behavioural or natural therapy components, should be instituted to reduce the number of acute attacks requiring medication and reduce overall medication use. Note that medication overusers typically fail to respond adequately to pharmaceutical prophylaxis and withdrawal of overused medications must usually precede preventative pharmacotherapy. If you have previously trialled and failed to respond to one or more prophylactic medicines, you require withdrawal treatment. If you have not previously trialled a prophylactic medicine, you will probably be prescribed a trial of prophylactic medicine before a withdrawal attempt is made.

• #91 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

  Triptans 12 doses per week; […] Codeine once a month or preferably not at all; […] Ergot alkaloids never; […] Injected narcotics once every 2 months. […] Medications containing caffeine, opioids or tranquilisers should be avoided. Early prophylaxis, which may involve medication, behavioural or natural therapy components, should be instituted to reduce the number of acute attacks requiring medication and reduce overall medication use. Note that medication overusers typically fail to respond adequately to pharmaceutical prophylaxis and withdrawal of overused medications must usually precede preventative pharmacotherapy. If you have previously trialled and failed to respond to one or more prophylactic medicines, you require withdrawal treatment. If you have not previously trialled a prophylactic medicine, you will probably be prescribed a trial of prophylactic medicine before a withdrawal attempt is made.

• #92 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

  Triptans 12 doses per week; […] Codeine once a month or preferably not at all; […] Ergot alkaloids never; […] Injected narcotics once every 2 months. […] Medications containing caffeine, opioids or tranquilisers should be avoided. Early prophylaxis, which may involve medication, behavioural or natural therapy components, should be instituted to reduce the number of acute attacks requiring medication and reduce overall medication use. Note that medication overusers typically fail to respond adequately to pharmaceutical prophylaxis and withdrawal of overused medications must usually precede preventative pharmacotherapy. If you have previously trialled and failed to respond to one or more prophylactic medicines, you require withdrawal treatment. If you have not previously trialled a prophylactic medicine, you will probably be prescribed a trial of prophylactic medicine before a withdrawal attempt is made.

• #93

  https://www2.hse.ie/conditions/migraine/treatment-and-prevention/

  To reduce your chances of having migraine attacks, you can: […] take medicines that prevent migraine attacks. […] Your GP may prescribe medicines to prevent attacks if you: […] avoid triggers but you still have migraine attacks […] Medicines include: […] You may need to take a medicine for a few months before you can see if it works. […] If medicines to treat or prevent migraine do not help, your GP may refer you to a migraine clinic. […] If medicines do not suit you or do not help to prevent migraines, you can try acupuncture. […] Keeping a migraine diary can help you identify possible triggers and how well medicines work. […] These migraine attacks usually happen from 2 days before the start of your period, to 3 days after. […] It may be possible to prevent them with: […] You take the medicines as tablets 2 to 4 times a day from either the start of your period or 2 days before.

• #94

  https://www2.hse.ie/conditions/migraine/treatment-and-prevention/

  To reduce your chances of having migraine attacks, you can: […] take medicines that prevent migraine attacks. […] Your GP may prescribe medicines to prevent attacks if you: […] avoid triggers but you still have migraine attacks […] Medicines include: […] You may need to take a medicine for a few months before you can see if it works. […] If medicines to treat or prevent migraine do not help, your GP may refer you to a migraine clinic. […] If medicines do not suit you or do not help to prevent migraines, you can try acupuncture. […] Keeping a migraine diary can help you identify possible triggers and how well medicines work. […] These migraine attacks usually happen from 2 days before the start of your period, to 3 days after. […] It may be possible to prevent them with: […] You take the medicines as tablets 2 to 4 times a day from either the start of your period or 2 days before.

• #95 Migraine Prophylaxis in Adults | Doctor

  https://patient.info/doctor/migraine-prophylaxis-in-adults

  Preventative options for menstrual migraine include: Standard prophylaxis options as discussed above, taken continuously. […] Arrange follow-up to monitor effectiveness, titrate dose and assess for adverse effects. […] Consider the need for referral to neurology if prophylactic treatment in primary care fails, is not appropriate or any red flags or atypical clinical features develop.

• #96 Current and emerging evidence-based treatment options in chronic migraine: a narrative review | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-1038-4

  The first-line treatment of CM is pharmacological. […] An improvement in the use of appropriate prophylactic medication is clearly needed to reduce the burden of CM in Italy. […] To make best use of prophylactic therapies such as OBT-A and anti-CGRP antibodies, it is therefore important to identify patients with CM and offer them prophylactic treatment as early as possible. […] In addition to ensuring that patients with CM receive the best available prophylactic medication early after the onset of chronicity, prevention of chronification in patients with high-frequency EM would also help to limit the burden of CM and should be prioritised. […] Although in this review we focus on the pharmacological prevention of CM, patient education, lifestyle factors, overuse of acute medication, and comorbidities all need to addressed in a multidisciplinary treatment plan to ensure optimal management of CM.

• #97 Chronic Daily Headache: Understanding and Treating It

  https://www.psychiatrictimes.com/view/chronic-daily-headache-understanding-and-treating-it

  Chronic primary daily headache may not be a singular disorder but rather one with various subtypes. Chronic migraine (also referred to as evolved migraine or transformed migraine), chronic tension-type headache, newly defined daily persistent headache, hemicrania continua, and post-traumatic headache are now recognized as subcategories of chronic daily headache. […] All these new daily persistent headache subtypes can be intensified by the overuse of medication, which, when taken in excess, can increase the duration, severity, and frequency of the headache beyond 15 days per month, and thereby transform the episodic headache into chronic daily headache. […] Management of chronic daily headache is complex and difficult. Successful therapy depends on a good history and an accurate evaluation of the qualities of the chronic daily headache (ie, its inception, early episodic qualities, and what the patient has done to address symptoms). Aggressive management must include nonpharmacological therapies, such as appropriate management of sleep, diet, and exercise; the elimination of offending stimuli, such as caffeine, nicotine, monosodium glutamate, artificial sweeteners, chocolate, and alcohol; and frequent periods of rest and relaxation. […] Early introduction of preventive therapy is an important antecedent to withdrawal therapy. A number of strategies can be effective. Preventive medication should be assessed every 2 months for continued efficacy.

• #98 Chronic Daily Headache: Understanding and Treating It

  https://www.psychiatrictimes.com/view/chronic-daily-headache-understanding-and-treating-it

  Chronic primary daily headache may not be a singular disorder but rather one with various subtypes. Chronic migraine (also referred to as evolved migraine or transformed migraine), chronic tension-type headache, newly defined daily persistent headache, hemicrania continua, and post-traumatic headache are now recognized as subcategories of chronic daily headache. […] All these new daily persistent headache subtypes can be intensified by the overuse of medication, which, when taken in excess, can increase the duration, severity, and frequency of the headache beyond 15 days per month, and thereby transform the episodic headache into chronic daily headache. […] Management of chronic daily headache is complex and difficult. Successful therapy depends on a good history and an accurate evaluation of the qualities of the chronic daily headache (ie, its inception, early episodic qualities, and what the patient has done to address symptoms). Aggressive management must include nonpharmacological therapies, such as appropriate management of sleep, diet, and exercise; the elimination of offending stimuli, such as caffeine, nicotine, monosodium glutamate, artificial sweeteners, chocolate, and alcohol; and frequent periods of rest and relaxation. […] Early introduction of preventive therapy is an important antecedent to withdrawal therapy. A number of strategies can be effective. Preventive medication should be assessed every 2 months for continued efficacy.

• #99 Current and emerging evidence-based treatment options in chronic migraine: a narrative review | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-1038-4

  Patients with chronic migraine require prophylactic therapy to reduce the frequency of migraine attacks, but the only currently available evidence-based prophylactic treatment options for chronic migraine are topiramate and onabotulinumtoxinA. […] Improved prophylactic therapy is needed to reduce the high burden of chronic migraine in Italy. […] Establishing a culture of prevention is essential for reducing the personal, social and economic burden of chronic migraine. […] All patients with CM need prophylactic treatment to reduce the headache frequency, severity and associated disability. […] However, low proportions of patients who are candidates for prophylactic treatment actually receive it. […] This review summarises strategies for the prophylactic treatment of CM, and highlights the importance of creating a culture for the timely prevention of CM.

• #100 Migraine treatment and prevention | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine-treatment-and-prevention/

  Preventing migraine is important to maintain a generally healthy lifestyle, including regular exercise, sleep and meals, ensuring you stay well hydrated, limiting your intake of caffeine, and limiting your intake of alcohol. […] One of the best ways of preventing migraine is recognising the things that trigger an attack and trying to avoid them. […] Medication is available to help prevent migraine attacks. Preventive medication is normally used if your migraine headaches remain frequent (more than 1 migraine attack per week) following a period of avoiding possible triggers. […] Preventive medication is not a cure for migraine attacks. The aim is to reduce how severe and often migraine attacks occur. A good response to preventive medication would be a 30% to 50% reduction in frequency and severity. […] You might be offered advanced therapies for migraine that can only be prescribed by a neurologist. […] If other treatments aren’t controlling your migraine headaches, you might be referred to a specialist migraine clinic for further treatment.

• #101 Migraine treatment and prevention | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine-treatment-and-prevention/

  Preventing migraine is important to maintain a generally healthy lifestyle, including regular exercise, sleep and meals, ensuring you stay well hydrated, limiting your intake of caffeine, and limiting your intake of alcohol. […] One of the best ways of preventing migraine is recognising the things that trigger an attack and trying to avoid them. […] Medication is available to help prevent migraine attacks. Preventive medication is normally used if your migraine headaches remain frequent (more than 1 migraine attack per week) following a period of avoiding possible triggers. […] Preventive medication is not a cure for migraine attacks. The aim is to reduce how severe and often migraine attacks occur. A good response to preventive medication would be a 30% to 50% reduction in frequency and severity. […] You might be offered advanced therapies for migraine that can only be prescribed by a neurologist. […] If other treatments aren’t controlling your migraine headaches, you might be referred to a specialist migraine clinic for further treatment.

• #102 Never Too Young For Chronic Headaches in Teenagers

  https://americanmigrainefoundation.org/resource-library/never-too-young-for-chronic-headaches/

  Natural history studies have shown that chronic daily headache can resolve in many children although the symptoms may last months to years. […] It is hoped that with successful identification of this syndrome and aggressive pharmacologic and nonpharmacologic management the average duration of chronic daily headache in children could be considerably less.

• #103 Migraine Prophylaxis in Adults | Doctor

  https://patient.info/doctor/migraine-prophylaxis-in-adults

  Preventative options for menstrual migraine include: Standard prophylaxis options as discussed above, taken continuously. […] Arrange follow-up to monitor effectiveness, titrate dose and assess for adverse effects. […] Consider the need for referral to neurology if prophylactic treatment in primary care fails, is not appropriate or any red flags or atypical clinical features develop.

• #104 Current and emerging evidence-based treatment options in chronic migraine: a narrative review | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-1038-4

  The recent introduction of OBT-A and positive phase II and III clinical trial results with anti-CGRP monoclonal antibodies for the prophylactic treatment of CM offers new hope for the many patients with CM who are currently not taking any prophylactic therapy or benefitting from their current treatment. […] To reduce the risk of diagnostic error and avoid incorrect treatment practices with topiramate, OBT-A and anti-CGRP monoclonal antibodies, patients with CM should be managed at specialist headache centers, where they will receive a high level of multidisciplinary care.

• #105 Migraine treatment and prevention | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine-treatment-and-prevention/

  Preventing migraine is important to maintain a generally healthy lifestyle, including regular exercise, sleep and meals, ensuring you stay well hydrated, limiting your intake of caffeine, and limiting your intake of alcohol. […] One of the best ways of preventing migraine is recognising the things that trigger an attack and trying to avoid them. […] Medication is available to help prevent migraine attacks. Preventive medication is normally used if your migraine headaches remain frequent (more than 1 migraine attack per week) following a period of avoiding possible triggers. […] Preventive medication is not a cure for migraine attacks. The aim is to reduce how severe and often migraine attacks occur. A good response to preventive medication would be a 30% to 50% reduction in frequency and severity. […] You might be offered advanced therapies for migraine that can only be prescribed by a neurologist. […] If other treatments aren’t controlling your migraine headaches, you might be referred to a specialist migraine clinic for further treatment.

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

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

  Monoclonal antibodies […] This new class of migraine-prevention therapies target the calcitonin gene-related peptide (CGRP) pathway, a protein linked to migraine symptoms. […] Providers suggest taking acute headache treatments no more than 10 days each month, because overindulging in either over-the-counter drugs or triptans can cause headaches. Medication overuse underlies many cases of episodic migraines that become chronic. […] „For people finding they need to take a lot of breakthrough medications, gepants would be a good option because they’re less likely to develop rebound headaches,” she says. […] 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. […] Lifestyle changes are also key, Dr. Shadbehr says. Getting enough sleep, hydrating and limiting caffeine can all ease headache symptoms. Keeping a migraine diary can also help you and your provider identify your patterns and personal food triggers. […] There are individualized treatment plans available to help alleviate chronic headaches and improve your quality of life.

Zobacz więcej