How should we treat chronic daily headache when conservative measures fail?

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How should we treat chronic daily headache when conservative measures fail?

Please use this identifier to cite or link to this item: http://hdl.handle.net/10355/11927

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Title: How should we treat chronic daily headache when conservative measures fail?
Author: Junker, Jessie A.; Aitken, Paul V., Jr.; Flake, Donna
Keywords: primary headache disorder
Date: 2004-10
Publisher: Family Physicians Inquiry Network
Citation: Journal of Family Practice, 53(10) 2004: 825-827.
Abstract: For the purposes of this review, we considered conservative measures to include such therapies as nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and acetaminophen with codeine. Amitriptyline is the best-supported option for the treatment of chronic daily headaches for those patients who have not been treated by conservative measures (strength of recommendation [SOR]: A, based on a metaanalysis of randomized controlled trials [RCTs]). For patients who overuse symptomatic headache medications, medication withdrawal is effective (SOR: B, based on a systematic review of cohort and case-control studies). Additional therapies include other tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and prophylactic treatments for migraine (SOR: B).
URI: http://hdl.handle.net/10355/11927

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