Diet and Health FAQ

Tagged As: Chronic Tension Headache Treatment

Question:
I was just diagnosed by my internist with Chronic Tension Type Headaches. He first prescribed Butalbitol with Acetominophen. After reading the patient information and discovering this drug decreases the effectiveness of birth control pills, which I take, I asked my doctor for a different medication. He said my only other choice would be a narcotic and prescribed Darvocet. This does not make sense to me. I have headaches pretty much every day and cannot imagine taking Darvocet every day long term. I have been doing some research and am finding that some doctors suggest low doses of tricyclic antidepressants or other pain relievers such as Midrin. Anyone with experience in this area who would like to respond is welcome

Answer:
Your research is correct. Long term use of narcotics are not the first line of treatment for chronic headaches, they are generally only prescribed that way after other preventives (like tricyclic antidepressants) have failed to help. Also the first rx he gave you, butalbitol with acetominophen (commonly known by the brand name, fiorocet) contains 40mg of caffeine per pill, and if used on a daily basis will likely cause rebound headaches and make your situation worse. There are lots of things to try before long term narcotics, i.e., the tricyclics, SSRI antidepressants, beta blockers, anti-seizure meds, etc. Many people get relief from pretty low doses of those meds. Unfortunately, they haven't helped me. I'm still taking an antidepressant (effexor). and my dr. keeps increasing the dosage, but so far no results. So I am taking narcotics, they help somewhat. I really think you need to see a neurologist (preferably a headache specialist), as they are much more aware of what meds and other treatments work for chronic headaches than an internist.