Headache is one of the most common conditions presenting to the neurology clinic, yet a significant proportion of these patients are unsatisfied by their clinic experience. Headache can be extremely disabling; effective treatment is not only essential for patients but is rewarding for the physician. In this first of two parts review of headache, we provide an overview of headache management, emerging therapeutic strategies and an accessible interpretation of clinical guidelines to assist the busy neurologist.

Medications for Headaches

Different types of medicine treat different types of headaches.

Tension headaches: Pain relievers like acetaminophen, aspirin, ibuprofen, or naproxen usually help. But be careful. Taking too many of these pills can cause hard-to-treat rebound headaches. If you need to take these drugs often, see your doctor. Don’t give aspirin to anyone under age 19 — it raises their chance of having a serious condition called Reye’s syndrome.

Migraine headaches: One class of drug, called triptans, is the mainstay of migraine treatment. They include eletriptan (Relpax), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), zolmitriptan (Zomig), and others. You can take them as pills, shots, or nasal spray

A form of ergotamine, called dihydroergotamine (DHE), also treats migraine headaches. You can get it as a shot or as a nasal spray.

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) also can help if you take them at the first sign of a migraine attack. NSAIDs also include ibuprofen and naproxen..