Headache Pearls by Larry Robbins. M.D.
REFRACTORY HEADACHES: MEDICATIONS
* Botox
* Opiods
* MAOI’s
* Stimulants
* Frequent (daily) triptans
MAOI’s
* Ideal patient:
Refractory headaches, depression, no insomnia, no weight loss, mature and responsible
* Phenelzine (Nardil), low doses at night
* May help headache and depression
STIMULANTS
* Help comorbidities (ADHD, fatigue)
* Mild analgesic effect
* Occasionally, they increase headache
* May help weight (temporarily)
* Low doses
FREQUENT TRIPTANS
* Rebound is a concern
* Efficacy:
For some, only medications that help
* Safety:
Probably relatively safe