Chronic Pain > Headaches > Headache Medications



There are a variety of medications on the market that can treat headaches. These include over the counter and prescription medications as well as herbal supplements, homeopathic and even natural (home-based) remedies.

Some of these medications include:

NSAIDs such as Refecoxib (Vioxx), a new class of COX-2 inhibitors that reduce adverse effects on both the gastrointestinal and cardiovascular systems.

Ergo (or Ergot) Derivatives, such as ergotamine tartrates - (Ergostat SL, Cafergot, Wigraine) should be limited to 2 times a week because rebound headaches can result. This was the first effective migraine medication developed. However, they often contain caffeine. These types of medications do not relieve any other headaches save those for throbbing, cluster headaches.

Note - DHE is similar to ergotamine. However, it is the spray (or injectable form) of the medication. It is not supposed to have the rebound headache as a side effect.

Triptans - A very effective medication for migraines, when used soon after headache begins. Triptans come from the tryptamine family of medications. The most common side effect reported is migraine recurrence. Triptans are not recommended for folks with coronary artery (heart) disease or those taking the ergotamine class of medications. They can also cause problems for those taking ceetain antidepressants, leading to serotonin syndrome, a potentially life-threatening condition marked by changed in mental status, gastrointestinal symptoms and neuromuscular abnormalities among others.  Examples of tryptamine medications include: sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), and zolmitriptan (Zomig).

Lidocaine is a nasal spray that can relieve migraine pain rapidly, but relief lasts only 10-15 minutes. Relapse of headache may occur. However, in an emergency situation, lidocaine is often the first response treatment.

Corticosteroids such as prednisone or dexamethasone are generally considered 'transitional treatments' for headaches. They are sometimes used to break the cycle of cluster headaches. They are often paired with other medications that stop or prevent additional headaches during the cluster cycle.

Mixed Analgesics with and without codeine include acetaminophen/codeine, and isometheptene (Midrin).  Midrin, which is a combination of isometheptene, acetaminophen, and dichloralphenazone, should not be used if you are using monoamine oxidase inhibitors, or if you have coronary artery disease.

Magnesium Sulfate provides "somewhat effective" results for migraine sufferers with low magnesium levels.

Neuroleptics, aka antipsychotics, provides symptomatic pain relief for migraine-induced nausea and vomiting. Examples include metoclopramide (Reglan), chlopromazine (Thorazine), prochlorperazine (Compazine), perphanazine (Trilafon), promethezine (Phenergan), Trimethobenzamide (Tigan), haloperidol (Haldol), droperidol (Inapsine), olanzapine (Zyprexa). Low blood pressure, confusion, and sleepiness are potential side effects.

Of course, it's important to note that these categories are by no means comprehensive. There are a variety of other treatments for headaches that we will continue to explore in this website including alternative, homeopathic and home-based (or natural) remedies.

Chronic Pain | Medications
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