Q. My sister has a headache that does not subside with pain medications. Please help.
Hello,
My sister has headaches from the last six months. Earlier, it was random, but from the last two months, it is continuous. The magnetic resonance imaging (MRI) is normal and no medicines are working. Please help.
Hello,
Welcome to icliniq.com. It could be a migraine or tension type headache. Please revert with the following details: 1. Are the headaches one-sided or on both sides? 2. Are the headaches pulsating in nature? 3. Is the frequency daily or intermittent? 4. Is it associated with nausea or vomiting?
Hi doctor,
Thanks for your reply. The headaches could be one sided, both-sided or even in the entire head. Yes, it is pulsating in nature. Initially, it was intermittent, but from the last two months, it is every day. Until a few days ago, there was a relief after taking the medicines, but now, there is no relief with medicines. It is not associated with vomiting or nausea.
Hello,
Welcome back to icliniq.com. Your sister seems to be suffering from a migraine headache and with prophylaxis, gradually, the severity and the frequency of attacks will reduce and even stop. The drugs are decided based on the frequency, and severity of the headaches. Sleep disturbances are also taken into account. For prophylaxis, the most commonly used drugs are Flunarizine, Propranolol, and Amitriptyline. In the case of an acute pain Triptans like Sumatriptan and Rizatriptan are used. In the case of an acute pain which does not respond to Triptans, we use pain killers like Diclofenac. She will also need to modify her lifestyle as follows: 1. She should sleep for at least eight hours at night. 2. Go to bed at the same time every night. 3. Avoid sleeping in the day to prevent sleep disturbances at night. 4. Avoid caffeine, lemon, and cheese in your diet. So, at this point, I suggest she be put on Flunarizine 10 mg and Amitriptyline 10 mg every night. Please discuss with your doctor regarding my suggestions. If you have any further query, please ask.
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