Managing Headaches for Patients: Diagnosis and Treatment (Health Care Professional Point of View)

As a healthcare professional, one of the most frequent problems patients will complain about is headaches. That's because headaches are a symptom of several health conditions. Malaria, typhoid, several infections such as meningitis, brain tumor, and inflammation are to mention but a few.

But headaches also occur on their own without being a symptom of some underlying condition. This is known as a primary headache. A secondary headache is one resulting from another health condition.

Note that most patients will not be aware of the kind of headache they suffer and will only tell you they have a headache that's either recurring, chronic, or comes with other symptoms. To diagnose primary headaches more quickly, you could check a headaches chart that suggests the most likely disease based on the symptoms you input. This would prevent you from carrying out time-consuming tests.

However, a more critical medical examination may be required if it's not a primary headache but a secondary one.

Headache medications

After determining the cause and nature of your patient's headache, the next step is prescribing medications to manage the pain.

Medications to treat headaches are grouped into three:

1. Symptomatic relief

2. Abortive therapy

3. Preventative therapy

1. Symptomatic relief

Medications for symptomatic relief target the headache along with other symptoms associated with it, such as nausea and vomiting. You may not need to formally prescribe such medications since most of them are available over the counter.

Over-the-counter medication for symptomatic relief of headache includes:

• Aspirin

• Paracetamol/acetaminophen

• Ibuprofen

• Naproxen sodium (NSAID)

 The last two are not recommended in pediatric patients.

Prescription medication for symptomatic relief of headache include:

• Antiemetics promethazine HCI

• Chlorpromazine

• Prochlorperazine

• Trimethobenzamide HCI

• Metoclopramide HCI

• Ondansetron HCI

 All of the above medications are generic names. They typically come under various brand names.

Also, some of these medications are known to come with mild to severe side effects, including nausea, vomiting, drowsiness, dizziness, and disturbed coordination, among others. Kindly research and inform your patient about the side effects when prescribing such medications for them.

2. Abortive therapy

Medications for headache abortive therapy typically address the process that causes the headache pain. They are often used in the early stages of migraine headaches as this is the time they're most effective.

Consider using intravenous drugs at an infusion suite when a migraine headache has lasted over 24 hours, and other medications have failed.

Medications for abortive therapy include:

• Ergot

• Dihydroergotamine

• Mesylate

• Triptans

• Eletriptan

• Rizatriptan

 Headache abortive therapy drugs also often come with side effects and are ill-advised for children under 12.

3. Preventive therapy

Even after you have successfully treated the headache, there may be a need to prevent the headache (and other associated symptoms) from returning. In such situations, consider prescribing a preventative measure. 

Preventative drugs for headache pain include

Antidepressants

Beta-blockers

Anti-seizure medications

NSAIDs

Botulinum toxin.

Although one drug is preferred, you can combine a multiple if one isn't effective. However, inform your patients of the risks of drug misuse and abuse.

 Note: prevention strategies for headaches vary and usually depend on the cause. They are also not recommended for children.

Sometimes, something as simple as a massage may be all your patient needs to cure their headache. You may also advise them to consume more vitamins and minerals from vegetables. Of course, good health often starts with good food.

Cover Photo Credit: Photo by Jonathan Borba on Unsplash

This is a collaborative post. Thank you so much for everyone who contributes to Glitz and Glam By Tiff