Treatment and Prevention
Since tension headaches are caused by factors such as neck strain, stress, and anxiety, treatment involves eliminating the stressful situation, if possible. Taking an over-the-counter pain reliever such as acetaminophen* or ibuprofen and finding ways to relax, rest, correct poor posture, and exercise can all help to relieve and prevent headache pain.
Cluster headaches respond poorly to over-the-counter medications. Oxygen therapy and prescription medications such as lithium, calcium channel blockers (used also to treat high blood pressure), steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and some antimigraine medications, among others, can help in many cases. If you suspect that you have cluster headaches, you should check with your doctor.
Sinus headaches usually require antibiotics or other treatments to clear up the infection. Once the infection is gone, the headache will go away, too. Until the infection gets better, taking an over-the-counter pain reliever can help ease the pain.
Migraines can be treated with over-the-counter pain relievers, such as aspirin, acetaminophen, or ibuprofen, if the headaches are mild.
Stronger medications may need to be prescribed if the headaches are more severe. These can be divided into two groups:
Acute treatments:
- pain relievers containing codeine, or some other narcotic medication
- NSAIDs
- ergot derivatives (e.g., ergotamine)
- serotonin agonists called "triptans" (e.g., sumatriptan, zolmitriptan)
- dopamine antagonists (e.g., metoclopramide, prochlorperazine)
Preventive treatments:
- beta-blockers (e.g., propranolol)
- low-dose antidepressants such as amitriptyline
- antiseizure medications (e.g., valproate, gabapentin, topiramate)
- pizotifen
- methysergide (no longer available in the US)
- avoiding headache triggers
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
Jeffrey Heit, MD, Internist with special emphasis on preventive health, fitness and nutrition, Philadelphia VA Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.