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Often they are treated similar to migraines. [24] A number of medications have been used including amitriptyline, gabapentin, pregabalin, propranolol, and topiramate. [25] [26] There are no prospective placebo controlled trials of preventive treatment. In those with migrainous features treatment may be similar to migraines. [27]
Dihydroergotamine (DHE), sold under the brand names D.H.E. 45 and Migranal among others, is an ergot alkaloid used to treat migraines. [7] It is a derivative of ergotamine. It is administered as a nasal spray or injection and has an efficacy similar to that of sumatriptan. Nausea is a common side effect. [8]
It is a commonly used medication for the treatment of neuropathic pain caused by diabetic neuropathy, postherpetic neuralgia, and central pain. [11] It is moderately effective: about 30–40% of those given gabapentin for diabetic neuropathy or postherpetic neuralgia have a meaningful benefit. [12]
Experts explain proven and new rescue therapies and migraine prevention protocols as well as which patients should and shouldn't try them. How to Find the Best Treatment for Your Migraines Skip to ...
Adverse reactions related to topiramate treatment occurred in 82.5% of 328 subjects who took part in an extensive trial covering 46 different centres. Most commonly reported were paresthesia (28.8%), upper respiratory tract infection (13.8%, and fatigue (11.9%) [42] Topiramate has evidence in preventive treatment of chronic migraine. [43]
Multiple sources recommend multimodal treatment, which is a combination of medicinal and non-medicinal remedies. [5] Some treatments are controversial and are still being tested for effectiveness. Suggested treatments for chronic headaches include medication, physical therapy, acupuncture, relaxation training, and biofeedback.
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