By Lawrence Robbins
This state-of-the-art ebook will conceal quite a few facets of headache administration, with a spotlight on tricky sufferers. sensible, step by step suggestion for treating difficult complications, together with migraine, refractory and cluster complications, should be supplied intimately besides the best way to procedure sufferers of other a while and people with mental problems. special and intricate case stories and entire causes to the sizeable array of medicines can also be featured. Authored by way of one of many prime specialists on refractory complications, complex Headache administration could be a useful consultant for the resident or clinician and an easy-to-read source for plenty of patients.
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Additional info for Advanced Headache Therapy: Outpatient Strategies
Botox is the only onobotulinum toxin A that is FDA-approved for the treatment of chronic migraine. It is relatively safe and only takes a few minutes to inject. One set of injections can decrease headaches for 1–3 months. There also is a cumulative benefit, in which the headaches continue to improve over 1 year of injections. Botox may be safer than many of the medications that are used for headache. Botox does not cause the “annoying” side effects that are commonly encountered with preventives.
Antihypertensives and Muscle Relaxants The antihypertensive meds are useful as preventives: β-blockers and calcium channel blockers are the ones most commonly prescribed. There have been studies on the angiotensin renin blockers (ARBs). We encounter fewer side effects with ARBs. Tiredness and weight gain are major problems in migraineurs, and β-blockers exacerbate fatigue and weight gain. So I often use one of the ARBs: Candesartan (Atacand) is the primary ARB that’s been studied, but others have been utilized.
In this particular study, no long-term adverse effects were found. The patients averaged near-daily triptans for almost 4 years . I do not encourage frequent use, but many people do lapse into it. The physician must attempt to withdraw the person from frequent triptans for a period of time, and assess for MOH. There are CM sufferers who do well only with the triptans. Refractory Patients: Stimulants A case can be made for utilizing stimulants in selected patients. They may help with fatigue, concentration, and moods.
Advanced Headache Therapy: Outpatient Strategies by Lawrence Robbins