Medical management of adult headache

Otolaryngol Clin North Am. 2014 Apr;47(2):221-37. doi: 10.1016/j.otc.2013.11.002. Epub 2013 Dec 19.

Abstract

We review the therapies for primary headache disorders: migraine, chronic migraine, tension-type headache, and cluster headache. Recommendations follow the evidence-based treatments so far as is possible with expert opinion to give clinical guidance. Headache has 2 levels of care: acute treatments designed to stop a headache from progressing and alleviate all symptoms associated with the headache and preventive therapies for patients whose headache frequency is such that by itself produces significant disability and impact on quality of life, or where the frequency of use of acute medications, regardless of efficacy, poses risks in terms of overuse or adverse events.

Keywords: Analgesics; Anti-epileptic drugs; Beta blockers; Natural therapies; Nonsteroidal anti-inflammatory drugs; Triptans; US consortium guideline.

Publication types

  • Review

MeSH terms

  • Analgesics / adverse effects
  • Analgesics / therapeutic use
  • Antidepressive Agents, Tricyclic / adverse effects
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Botulinum Toxins, Type A / adverse effects
  • Botulinum Toxins, Type A / therapeutic use
  • Clinical Trials, Phase III as Topic
  • Headache / drug therapy*
  • Headache / prevention & control
  • Humans
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / prevention & control
  • Randomized Controlled Trials as Topic
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Tension-Type Headache / drug therapy
  • Tension-Type Headache / prevention & control
  • Tryptamines / adverse effects
  • Tryptamines / therapeutic use

Substances

  • Analgesics
  • Antidepressive Agents, Tricyclic
  • Serotonin Uptake Inhibitors
  • Tryptamines
  • Botulinum Toxins, Type A