often effective for relieving the pain of headache
once it develops. Severe headache of any type
may require narcotic analgesic medications to
relieve the pain. The exception is cluster
headache, for which preventive measures are
more effective because the headache, despite the
severity of its pain, generally lasts a shorter period
of time than it takes for analgesic medications to
achieve a therapeutic effect in the body. The herb
FEVERFEW, available as an over-the-counter dietary
supplement in the United States, is effective
against migraines for some people.
Medication is also the mainstay of prevention
for migraines and cluster headache, though pre-
vention approaches are more effective for
migraine than cluster headaches. Medications that
may prevent migraines and cluster headache
when taken on a regular basis include propra-
nolol, methylsergide, amitriptyline, valproic acid,
verapamil, and lithium carbonate. Triptans taken
at the first indication of migraine are effective for
many people in preventing the headache. Occa-
sionally a doctor may give an injection of narcotic
analgesic such as morphine. Sinus headaches may
require treatment with antibiotic medications for
infection or ANTIHISTAMINE MEDICATIONSfor allergic
rhinitis. Decongestant medications (nasal sprays,
nasal drops, or oral forms) may help sinus
headache of either type.Risk Factors and Preventive Measures
Risk factors for headaches include physical and
emotional stress, low blood GLUCOSEfrom missing
meals, exposure to environmental irritants such as
cigarette smoke, excessive CAFFEINEconsumption,
allergies or HYPERSENSITIVITY REACTION, foods that
contain tyramines (such as red wine, smoked
meats, and hard cheeses), and MENSTRUATION in
women. Preventive measures include relaxation
techniques and stress management methods,
avoiding known or suspected factors that precipi-
tate headache, and prophylactic (preventive) med-
ication. The right combination of approaches can
significantly reduce the frequency and severity of
chronic headaches.
See alsoACUPUNCTURE; LIVING WITH PAIN; NEURAL-
GIA; NEURON; NEURORECEPTOR; STRESS AND STRESS MAN-
AGEMENT.headache 377