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

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