Medications

Medications are only ONE part of a successful treatment plan. They are appropriate when they provide benefit, improve function and have either no or mild, manageable side effects. Importantly, medications (even if natural) are chemical substances not expected in the body, and as such have side effects. Some of the side effects might be unknown. The use of medications/drugs for any purpose requires patient consent, as this practice does NOT require a patient to use any medication without his or her full consent. The information presented here is based on the disclaimer you accepted when you entered this site. You can obtain additional information from the download section.

 

 

There are medications treatments for headaches, chronic pain and various neurological conditions.

 

Headaches: almost everyone has a headache here and there. Some have regular headaches. Those patients typically are offered various treatments for the recurrent headaches. Sometimes those treatments involve medication. Current research shows that there is a limit to the use of abortive therapies (like triptans or opioids). If a patient uses an abortive medication more than 8 days per month, there is a significantly increased risk of the headache transforming into a chronic daily headache rather than just an intermittent headache. Although long suspected, the research was presented at the American Academy of Neurology meeting in April 2008. For patients who have more than 8 days' of headaches per month, the use of prophylactic medication (medication that helps prevent headaches) is an important consideration.

Medications to help prevent headaches

There are many medications used to help prevent headaches from happening in the first place. Actually, these medications may do any or all of the following three things to headaches: reduce the frequency, reduce the severity, and/or reduce the duration. Currently, topiramate and a form of valproic acid are FDA-approved to be advertised for headache prevention. The neurological community employs several other medications that were intended originally to treat other conditions. Examples include some blood pressure medications, a specific antihistamine, a few specific older antidepressants, a specific memory loss medication, and more.

If headaches are occurring very frequently, then the patient should consider using a medication to reduce the frequency, in addition to the various options for stopping the headaches when they do come.

Medications to stop headaches when they occur

There are several categories of medication to help stop a headache when the headache occurs. A true migraine might be aborted with a triptan medication. NSAIDs, opioids and even nausea medications have been shown helpful in stopping headaches. In some cases, infusions of ergotamine and caffeine have been used.

Successful headache treatment typically requires avoidance of triggers (if known), good sleep habits, and for those with very frequent headaches, a combination of a preventative medication along with very judicious use of an abortive medication.

Chronic pain: a surprising percent of the population suffers chronic pain. There are many treatments for chronic pain that do NOT involve the use of a medication. What follows below is some information on medication concepts for chronic pain.

Medications to help reduce chronic pain - non-opioid

Although many people think of opioids (narcotics) in cases of chronic pain, many chronic pain patients do not need to use opioids. There are several classes of medications that have demonstrated significant benefit. There are the standard NSAIDs (like meloxicam or naproxen, for example), aspirin and acetaminophen. Although the over the counter doses many not be adequate, often the prescription strength doses are. There are also medications that can block various parts of the pain transmission pathways. These medications typically were invented for another purpose and are FDA-approved to be advertised for those other purposes. Somewhere along the way, clinical research proved them to be helpful for chronic pain. Blood pressure medications like clonidine, muscle agents like baclofen and tizanidine, and various antidepressants and seizures medications all can help reduce chronic pain through more than one mechanism.

Medication to help reduce chronic pain - opioid

Opioid medications, when we remove our emotional responses, have been proven the most effective medications for most chronic pain states. However, because these medications are controlled substances, there are additional legal issues, social issues and even medical issues associated with their use. While generally safe for the liver or kidneys, for example, the opioids do have major side effects (including death) and pose a risk of addiction, something that does not occur with the non-opioid pain medications. Please feel free to examine our opioid information sheet on the downloads page.

 

 

 

 

 

 

MEDICATIONS

 

Medications are only one part of a successful treatment regimen. Patients who employ physical modalities in addition to medication typically demonstrate greater improvement compared to those who use medications alone.

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