Preventatives for chronic daily headaches

[awkwardsitch]

I'm reluctantly having to explore preventative medication. I'm massively phobic of this following a genuine life threatening reaction to citalopram.

I suffer chronic daily headaches. I can't take beta blockers.

I can't also take any head med that will make me drowsy. I am a pre-prep teacher; I'm responsible for a class of five year olds. I simply have to be "with it" which rules out a lot of these type of drugs.

Any suggestions?

These are my symptoms.

Worse when I wake up but then eases. Other flares through the day with a few hours grace.

Forehead/temple/neck ache/squeezing

No nausea or vomiting

Not sensitive to light but it's more soothing in darker areas

At times a feeling of unreality

Migraine or tension? Previously a neurologist said tension headaches don't exist . I have historically suffered auras

@awkwardsitch I did mention it earlier but not sure if you commented, have you had your teeth/jaw checked with the dentist for bruxism? Clenching your teeth at night would explain the worse pain in the morning (my dentist explained it that if you try and clench your teeth in the day and call it a 5, whilst you're asleep it would be a 10.

A mouth guard has totally changed my headaches.

I spoke to th GP over the phone this morning. She's called me in this morning to rule out intracranial hypertension.

I'm fucking terrified.

I’ve had chronic daily headaches for over 20 years. I’ve tried various preventatives most of which did nothing - the only thing that worked for me was topiramate but that eventually stopped working.

What has really worked and transformed my headaches in the past 18 months is the combined oral contraceptive. I didn’t used to think that my migraines were hormonal but they dissapeared completly when I was pregnant and breast feeding and when the topiramate had them under control they got worse when I had my period (I managed that by upping the dose just before my period started and dropping back down a couple of days after). I’ve tried the mini pill and mirena coil (both progesterone only) and they made my head worse. I thought a combined pill was worth a try so persuaded my GP to let me try it (they were reluctant because I’m over 40) and it’s made a huge difference. I now go for up to 2-3 weeks with no headache and when I do get them it’s usually just for a day or so at a time which is a huge improvement. It’s a fairly simple solution with much fewer side effects than some of the other medications plus bonus of contraception so may be worth a try if you haven’t tried a combined pill before, or for a while - I also took it in my 20s with no effect on headaches.

I'm not allowed oestrogen due to history of aura migraines.

Yoga and a mouth guard have reduced my headaches

sparkle no, you have totally misunderstood me. I'm just pointing out the treatment has to match the cause and that the OP needs a diagnosis. I really do have a neurologist who can't help with my headaches, but can with my neurological condition.

I've had no trouble with NHS treatment either bear, but I think a lot is down to luck (and being a professor's project).

OP, put your fingers in your ears, press forward slightly (so you can feel your jaw joint) then press the joint harder and open your mouth wide. Does it hurt?

So... GP this afternoon:
Blood pressure a bit raised (nervous)
Backs of my eyes normal
Ears/throat normal so not sinus

She said "all I can do is give you reassurance that it's nothing sinister". She didn't want to give me more painkillers which could antagonise potential rebound headaches.

I had headaches for about 20 years and got fobbed off by doctors. I lost the plot in the doctors last year and they sent me to a doctor that actually asked me questions about my symptoms before I had even told him about it. As well as headache I would also get watery eye, bloodshot eye, would feel sick but also be hungry along with cold like symptoms. Pain also across the face. I can't actually remember name of what he diagnosed but it's something to do with a nerve that gets agitated. His advice:
No alcohol
No fizzy pop
No cafeine
Only 8 hours sleep no more or no less.

Been following this now for 6 months and I probBly get 1 headache a month compared to weekly. Cafeine I think is the mAin trigger- it's evil. Thank god for this doctor I feel like a new woman.

Have you had your eyes tested recently? If not, I strongly suggest that you do.

My headaches are virtually non existent since I gave up sugar. I follow a low carb high fat plan.

This is what I was going to say. I went on this diet for other reasons but quickly noticed that my very frequent headaches all but disappeared.

Cutting caffeine and sugar sounds awful but I'll try it. That's going to spur a crash headache isn't it first? I don't drink anyway.

sparkle I forgot to add that I'm prescribed 30/500 cocodamol so it's definitely not the case that no one with headaches should use it, but my headaches are obviously completely different to yours. I would also love a good night's sleep if I could, but unfortunately no matter how hard I try I can't (and I can't up my dose of amitriptyline any more apparently). I wish it was a one size fits all situation so that everyone would get treatment that worked quickly. I'm glad your treatment has worked for you. Hopefully the OP will soon. With that I think I'll hide this thread.

Cutting sugar isn't as hard as it seems once you get past the first few weeks (and I say this as someone with a massive sweet tooth). I do still allow myself a small bit of dark chocolate (milk chocolate is way too sweet now that I'm not used to it) from time to time. And when I do have sugar, I have it after a meal, never by its self. That's just asking for trouble.

I also limit starchy carbs and try to keep the carbs that I do eat to whole grain items.

@LivingInMidnight
Treatment hasn't worked for me, hence 10 years with chronic migraine. As you can see from the long list of medications I put on that I've tried and haven't worked. So you can see only too well I know that it is not a one size fits all situation.
The neurologist said the good sleep, adequate food & water, no caffeine, no pain killers is advice he gives to anyone with any type of headache disorder as they can worsen it.
I still have daily migraines. It took me about 3 years to get my sleep sorted to a state where I only wake up 5 times a night instead of about 20. Even this in itself has helped my migraines a little.
FYI in the early days GPs gave me dihydrocodeine to 'help' ease the pain. After about a year of taking them I saw the neurologist who said that taking coedine for chronic headaches is one of the worst things you can do as it causes rebound headaches. Not all doctors are on the same page.
At this stage I don't know if my migraines will ever get better. So I like to 'manage' the aspects that are in my control, I can work on my sleep hygiene, eating regular meals, drinking enough water, not drinking caffeine and not taking pain killers.

I've got a cancellation with a pain management specialist next Saturday

You don't necessarily have to cut all sugar and caffeine at the same time. I still eat sugary things but less frequently. Also By taking things away one at a time you can see what the trigger is .
For me it's tea which was hard to give up but thank god for
Decaf I can still pretend I'm having a proper brew.

Sparkle I too get daily migraines and sometimes several a day. How do yours nmanifest?