Can You Prevent Headaches?

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7 min read

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Preventing headaches involves a combination of pharmacological and behavioral strategies. While SSRIs and SNRIs are generally ineffective, tricyclic antidepressants, beta-blockers, and certain anticonvulsants show promise. Additionally, a shift from avoidance to coping with triggers may offer better long-term outcomes. A personalized, comprehensive approach is essential for effective headache prevention.

Headaches, including migraines and tension-type headaches (TTH), are common medical issues that significantly impact quality of life. Various strategies have been explored to prevent headaches, ranging from pharmacological treatments to behavioral approaches.

Key Insights

  • Pharmacological Treatments:
    • SSRIs and SNRIs: These medications are generally not effective for preventing migraines or TTH. SSRIs are no more effective than placebo for migraines and less effective than tricyclic antidepressants for TTH .
    • Tricyclic Antidepressants: These are more effective than SSRIs in reducing headache duration and the need for analgesics in TTH patients, though they come with more adverse events .
    • Beta-Blockers and Anticonvulsants: Propranolol and topiramate are effective for migraine prevention. Other effective medications include metoprolol, timolol, divalproex sodium, and sodium valproate .
    • Other Medications: Amitriptyline, gabapentin, candesartan, Petasites (butterbur), riboflavin, coenzyme Q10, and magnesium citrate have also been recommended for migraine prevention based on evidence and expert consensus .
  • Behavioral and Non-Pharmacological Approaches:
    • Avoidance vs. Coping with Triggers: Traditional advice to avoid headache triggers is being challenged. Evidence suggests that coping with triggers, rather than avoiding them, may be more effective. Short exposure to triggers can increase sensitivity, while prolonged exposure can decrease it .
    • Comprehensive Management: A holistic approach that includes both pharmacological and non-pharmacological strategies, tailored to individual patient needs, is recommended. This includes considering comorbid conditions and patient preferences .

 


Can you prevent headaches?

Tony Dickenson has answered Near Certain

An expert from University College London in Neuroscience

Yes. There are a number of drugs that are able to reduce the number of headache days through different mechanisms. Predicting who will respond to each therapy is less clear. The drugs include the triptans that modulate serotonin activity, beta blockers, botulinium toxin injections and the recent antiCGRP antibody therapies. The latter two have long durations of action.

 

Can you prevent headaches?

Arne May has answered Near Certain

An expert from University Medical Center Hamburg-Eppendorf in Neurology

There are more that 200 headache types, grouped into primary and secondary headaches. Primary headaches are diseases where the headache is itself the disease (for example migraine) and secondary, where headache is just a symptom of another disease (for example a brain tumor). Secondary headaches are treated when the underlying disease is treated (operation of the brain tumor). Primary headaches can be treated in 2 ways: acute treatment and preventative treatment.

The preventative treatment is based on medications and non-medical treatment (sport, behavioral therapy, acupunture etc). The medications are specific for each primary headache type (of which there are 5). Preventative treatment needs (depending on the drug used) 4-12 weeks until it is effective. Once effective (defined as at least 50% of headaches gone) one should treat for another 4-6 months and then taper down since in most patients the headache frequency stays low even without medication- until the headaches increase again and a preventative medication is again warranted. Important to know: around 70% of all patients have a benefit from a preventative treatment. Furthermore, usually a preventative medication is only taken for around half a year. There are exceptions such as chronic cluster headache and rare trigemino-autonomic headaches where the preventative needs to be taken longer.

 

Can you prevent headaches?

Antonio Russo has answered Near Certain

An expert from University of Campania Luigi Vanvitelli in Neurology

Among primary headaches, we can find three important types of syndromes all characterized by the key (but not exclusive) symptom of head pain: migraine (with or without aura), tension-type headache and cluster headache. 

Without a doubt, migraine can be prevented. This can be obtained by reducing the exposure to the recognized triggers and using the so-called preventive anti-migraine treatments. A preventive treatment can be pre-emptive, short-term, or maintenance. Pre-emptive treatments are used when well-identified triggers exist, and patients should be instructed to intake the drug before the trigger exposure (for example to prevent migraine attacks induced by physical exercises). Short-term treatments are used when patients are undergoing a time-limited exposure to a trigger factor, such as migraine attacks related to menstruation. These patients can be treated with daily medications, from 3 to 5 days, just before and during the menses. Finally, maintenance prevention is used when patients, due to the migraine attacks experienced in the course of the entire month, need ongoing treatment.

In the past years, to prevent migraine attacks, we have used several drugs prescribed for other conditions such as high blood pressure, depression or epilepsy. However, new preventive antimigraine treatments are now available such as Onabotulinumtoxin-A (the same toxin that is used for esthetic medicine) and the monoclonal antibodies direct to the pathway of CGRP (such as Erenumab, Galcanezumab and Fremanezumab). In the next future, some new drugs will became available such as Eptinezumab (another anti-CGRP monoclonal antibody) and Gepants. 

 

Can you prevent headaches?

Fayyaz Ahmed has answered Uncertain

An expert from Hull York Medical School in Neurology

You can only prevent headaches if you know what has caused them. There are triggers for a migraine attack. These triggers are many and often it is the combination of various triggers that cause headache and migraine. There are very few cases where there is a single trigger and hence they are able to prevent their headaches. For example some people know it is chocolate or red wine or cheese etc. However, as vast majority of cases it is the combination of different triggers, the only way you could prevent having a headache or migraine is to increase the body threshold of having a headache which is usually done through management of lifestyle factors i.e., healthy living with good balanced food, good night sleep, regular exercise, hydration etc. It can also be a preventive medication such as propranolol and amitriptyline which help raise the threshold making people resistant in getting headache and migraine.

 

Can you prevent headaches?

Anna Andreou has answered Near Certain

An expert from King’s College London in Neuroscience, Neurology

Headaches cannot be cured. However, several preventive therapies that reduce the frequency and severity of headache attacks are now available and patients should seek medical advice by their GP and headache specialist.  Additionally, lifestyle changes may help reduce the frequency of headache attacks, such as, consistent program with meal and sleep times, mild exercise, stress avoidance etc. Keeping a headache diary will aid doctors to better diagnose a headache condition and suggest appropriate treatments. 

 

Can you prevent headaches?

Amanda Ellison has answered Near Certain

An expert from Durham University in Psychology, Neuroscience

Yes. But it is always hard to quantify the things that don’t happen. However, good posture, hydration and stress management all prevent headaches. Changes in neurochemical balance can trigger behaviours such as chocolate craving or yawning that seek to change the concentration of serotonin or dopamine in the brain so we may prevent them without knowing. This is important in the case of migraine for example.

 

Can you prevent headaches?

Janet Bultitude has answered Likely

An expert from University of Bath in Psychology

It depends on the cause of the headache! For example, some headaches are caused by dehydration, and therefore can be prevented by making sure you drink enough water. This includes some hang-over headaches, by the way – so having a couple of tall glasses of water after a night out might just save you part of the pain the following morning. Other headaches are caused by things like inflamed sinuses (e.g. due to sickness), which you might have less control over.

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