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Headache Medications: Are They Worth It?

Apr 10, 2008
Too many times people with chronic headaches are told to "take these pills and all will be well". But what about those pills? Do they really help or is this just another way to throw medications at a problem? Well, just like anything else, there are pros and cons to taking headache medications.

Some of the classes of drugs used in headache and migraine treatment are frightening and many times people will read about one or two side effects and say "Hey! Not me! I'm not taking that drug." Unfortunately, they may be selling themselves short. Many of these medications are used in small, pediatric doses to treat migraines in adult patients.

But if the person doesn't know this, then they dismiss the drug.

Here are the most common classes of drugs used in migraine: anti-seizure, beta-blockers, ace inhibitors (anti-hypertensive), anti-inflammatories, anti-psychotics, triptans, opiods, anti-depressants and finally botox.

Each of these classes of drugs has their own side effect profile but usually, with most people, the side effects are far less due to the lower dosing used. Also it is very important to give each medication 90 days before assessing effectiveness. Actually, it takes the brain about that long to respond to medication! Additionally, if side effects are occuring, they may wear off in a few weeks, so you must ask yourself if they are tolerable until they wear off.

Each person must balance the effect of the medication against their pain level and make an individual decision about the drug. Keep in mind too, that just because medication of a certain class is being prescribed for your migraines (such as a low dose of an anti-seizure or anti-depressant), this does NOT mean you have seizures or are depressed! These drugs work in the brain in a certain way to "dampen" nerves and reduce pain. Unfortunately, at times, this may cause some dizziness, fatigue, even sedation. Now sedation can be a good thing if you have headaches and cannot get to sleep at night. In this case, take your medication at night.

If your headaches are severe, then you might want to consider multi-drug therapy. But slow down! Again don't get upset or dismiss the idea. More often than not, these medications are in place for a few months to a year until the brain "settles down" so to speak. For in reality, what is happening with migraines and other headaches is a hyper-excitable state in the brain. The nerves are just a bit fried, to put it mildly, after months and years of chronic pain.

So try to bear with it when someone suggests a new medication. Talk to your provider and discuss your fears about medications and what you expect to get from your treatment. No matter what, you have the right to be heard and understood when it comes to your medication and medical plan. You never know! This might just be the one that your brain really needs and could help with your migraines.
About the Author
Mary Kay Betz, MS RPA-C is a practicing Physician Assistant in Headache Medicine. For more information visit www.headache-adviser.com
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