Headache ranks among the most common pain complaint from the patients. Globally, 50% of adults are affected by it. But ironically it is the most under-diagnosed and under-treated medical condition.
Recurrent headache attacks are substantial enough to make a person incapable to perform their daily chores. Hence, they can be potentially catastrophic to a person’s life. Therefore, medication for headaches is paving their way through to make our life healthy once again.
Medication for Headaches
The treatment plan of headache is drawn according to the cause. While treating an underlying medical condition, most of the headaches go away. People experiencing most run-of-the-mill headaches often opted for over the counter medications. Hence, analgesics and NSAIDs for headaches have shown to be a good call for pain relief. This includes very common OTC medication for headaches such as acetaminophen, naproxen, and ibuprofen. But experiencing recurrent attacks with other symptoms may raise a red flag. So, one should seek medical attention as soon as possible. Such types of headaches are named as primary headache disorders.
Primary Headache Disorders
Headaches not occurring as a consequence of any underlying medical conditions are titled as Primary headaches. Nerves, muscles & vessels of the brain & neck are involved in it. These include:
- Migraine Headaches
- Tension Headaches
- Cluster Headaches
The episodic & disabling headache often lasts for few hours to few days. Hence, throbbing & pulsating pain become inevitable for a person.
The treatment of migraine falls into two major categories:
- Abortive treatment
- Preventive treatment
In abortive treatment, the goal is to immediately stop acute attacks of migraine headaches. NSAIDs have been a mainstay in managing primary disorders of headaches. These are the most commonly used anti-inflammatory for headaches. Furthermore, NSAIDs have shown to have less potential for causing rebound headaches. They are very useful when triptans are contraindicated. But they also inhibit cox-1, which isn’t desirable. So, one should monitor their dose & frequency of the drug.
Aleve for Migraine
Doctors often prescribe aleve (naproxen sodium) for migraine headaches. It is used to relieve mild to moderate pain.
The usual dose is 275 mg to 550 mg every two to six hours & may increase up to 825 mg if needed. However, abdominal discomforts have been reported in people administrating a dose of 825 mg. Pain is usually lower within two hours of taking it.
Moreover, a study shows that aleve for migraine is not clinically beneficial as a stand-alone analgesic. However, other NSAIDs can provide better relief than aleve.
But a combination of sumatriptan 100 mg with 500 mg naproxen is an effective choice for migraine relief.
Indomethacin for Migraine
Another NSAID for headache includes Indomethacin (Indocin).
It is very effective for preventing as well as treating acute migraine attacks.
Moreover, it is the drug of choice in the treatment of chronic paroxysmal hemicrania. A rare form of headache common in adults. It is marked by short, episodic & debilitating unilateral headaches. The positive response of indomethacin is often used as a diagnostic tool for such headaches. Because indomethacin provides sustained & complete relief from major symptoms of chronic paroxysmal hemicranias. A dose of about 150 mg/day for 3-4 days is beneficial. It could be an optimal drug in treating (CPH) related migraines. Effects are usually seen within 48 hours. But sometimes it may take as long as 5 days.
It is also very effective in treating stress-related or tension headaches. Due to its multiple-use, it can be regarded as the best Nsaid for headaches.
Also called stress headaches, is one the most common headache of this decade. People experiencing such headaches may have a very stressful or exertional schedule. Such headaches are very infrequent & short-live. It usually lasts for a few minutes to a few hours. However, a chronic tension headache can last up to a few days.
Diagnosis of such headaches includes a patient history of headaches & physical examination.
Tension Headache Medicines
Usually, people with tension headaches go for OTC medication for headaches & non-medical therapies.
NSAIDs again serve their purpose here for being an effective pain reliever. Hence, this mainly includes, aleve & Advil.
Tylenol(acetaminophen) basically an analgesic, is often used. Because it is more effective when to use in combination with other drugs.
Advil, a commonly used Nsaid for relieving tension headache. It also serves to alleviate mild to moderate migraine headaches. For episodic tension-type headache, the effective dose is 200 to 400 mg. Usually, a headache is relieved within 2 hours.
A combination of drugs beneficial for tension headache includes aspirin, acetaminophen & caffeine. It is selling in the US under the brand name, goody’s powder or Excedrin. They are commonly available over the counter.
This combination is specifically used to provide short term relief from neck, head & shoulder pain associated with tension & stress.
Unlike, the other types of headaches, cluster headache is usually not associated with food, hormonal change, or any kind of stress. The cluster headache can be characterized as a neurological pain that can occur in the form of groups. It lasts from 15 minutes to 3 hours. However, the scary part about these headaches is that they are really severe and can occur up to 8 times within 24 hours.
The cause of cluster headache is still to unfold. Rather, being peculiar about this headache, one needs to devise the treatment plan for this headache. There are two types of cluster headache:
Medication for Headaches of Cluster
One needs to know that there’s no specific treatment for cluster headache. Although, one can reduce the severe effects by using different medications enlisted below
- Local anesthetics
These are considered to be fast-acting treatments for the cluster headache. One shouldn’t use paracetamol, NSAID, opioid, and ergot in a capsule or tablet form to get relief from cluster headaches. Galcanezumab is the first FDA-approved drug for treating the severe frequency of episodic cluster headaches. It is available as 300mg injectable and it is a humanized IgG4 monoclonal antibody specific for calcitonin-gene related peptide (CGRP) ligand. The generic name of this drug is Emgality.
Acetaminophen vs Nsaid
One of the goals of headache treatment is to avoid medication overuse headache or rebound headache. Using analgesics for chronic headaches can trigger rebound headaches. Whereas, NSAIDs possess very low potential. Hence, the use of analgesics should be supervised closely. Because overuse could lead to such complications. Besides this, liver toxicity can be another risk factor in high doses.
Furthermore, acetaminophen is more effective for headaches while using it in combination with aspirin & caffeine. In pregnant women, acetaminophen is a choice of treatment for tension headaches. When used properly, it doesn’t affect the pregnancy.
But as NSAIDs possess mild to severe potential side effects, it’s very important to be in connection with your health care provider.