Use of Medication

Long-Term Medication Use

Some headache patients express concern about the long-term adverse effects of taking prescription medicines. Are there any known long-term harmful effects of taking daily preventive medications to treat headache?

Many migraine preventive medicines have been around for years, even decades, and their long-term use in therapeutic doses, when used under appropriate medical supervision, is considered generally safe. Though side-effects can be encountered with the use of any medication, both in the short and long term, such risks are reduced significantly with regular physician visits and evaluation. It must be stressed that even "safe" medications such as aspirin, Tylenol, and other over-the-counter medications can lead to disastrous consequences when used indiscriminately or excessively, which underscores the need to use any medication or herbal remedy only with proper medical advice.

Medication and Other Health Problems

What are the difficulties in treating a headache disorder in someone who has other significant health problems such as hypertension, asthma, or stomach ulcers?

It is of utmost importance to understand the health and health problems of the patient when treating head pain disorders, as many preventive and abortive medicines have potential to aggravate the underlying condition. Numerous medical disorders can be aggravated by choosing the wrong pain medication. However, with a good history and medical workup, it is sometimes possible for the physician to select one medication to treat both headache and a coexistent health disorder.

For example, migraine prevention with Depakote will address certain types of seizures and mood disturbance; Corgard is commonly used for hypertension; Pamelor treats depression, anxiety and sleep disturbance; and Prozac lends itself well in the management of anxiety and PMS disorders, among others. On the other hand, anti-inflammatory medications should be used with caution or not at all in those with a history of gastric ulcer disease, colitis or high blood pressure.

Common Medications

What are the common medications prescribed for MHNI patients?

Generally, MHNI patients are prescribed preventive medications, which are the medications a person takes on a daily basis in an effort to decrease head pain. Most head pain sufferers are also prescribed abortive medications to use when they have a bad headache. Hopefully, abortive medications will decrease a person's pain level.

Commonly prescribed prophylactic medications include tricyclic antidepressants (e.g., nortriptyline [Pamelor], amitriptyline [Elavil]); beta blockers (e.g., nadolol [Corgard], propranolol [Inderal]); serotonin specific reuptake inhibitors (e.g., fluoxetine [Prozac]); and antiseizure medications (e.g., valproate [Depakote]).

Side Effects

What about side effects of prescribed medications?

Side effects depend upon the medication prescribed and an individual's specific reaction to a given medication. Most side effects are temporary and will either improve or completely disappear with time. However, if the side effects are not improving or actually get worse, then a patient should contact their physician for an evaluation. Certainly if patients become sedated, have blurred vision, or feel dizzy or lightheaded, they should not drive a car, operate dangerous machinery, or perform any functions that require full alertness.

Certain side effects, such as a rash, hives, significant lightheadedness, difficulty breathing, and passing out should be immediately reported to your physician. In addition, most medications should not be taken during pregnancy.