Treatments and drugs

By Mayo Clinic Staff

Treatment for an underlying condition often stops frequent headaches. When no other condition is discerned, treatment focuses on preventing pain.

Prevention strategies vary, depending on the type of headache you have and whether medication overuse is contributing to these headaches. If you're taking pain relievers more than three days a week, the first step may be to wean yourself off these drugs with your doctor's guidance.

When you're ready to begin preventive therapy, your doctor may recommend:

  • Antidepressants. Tricyclic antidepressants — such as nortriptyline (Pamelor) — can be used to treat chronic headaches. These medications can also help treat the depression, anxiety and sleep disturbances that often accompany chronic daily headaches.

    Other antidepressants, such as the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac, Sarafem, others), may help in treating depression and anxiety, but have not been shown to be more effective than placebo for headaches.

  • Beta blockers. These drugs, commonly used to treat high blood pressure, are also a mainstay for preventing episodic migraines. Some beta blockers include atenolol (Tenormin), metoprolol (Lopressor, Toprol-XL) and propranolol (Inderal, Innopran XL).
  • Anti-seizure medications. Some anti-seizure drugs seem to prevent migraines and may be used to prevent chronic daily headaches, as well. Options include topiramate (Topamax, Qudexy XR, others), divalproex sodium (Depakote) and gabapentin (Neurontin, Gralise).
  • NSAIDs. Prescription nonsteroidal anti-inflammatory drugs — such as naproxen sodium (Anaprox, Naprelan) — may be helpful, especially if you're withdrawing from other pain relievers. They may also be used periodically when the headache is more severe.
  • Botulinum toxin. OnabotulinumtoxinA (Botox) injections provide relief for some people and may be a viable option for people who don't tolerate daily medication well.

Unfortunately, some chronic daily headaches remain resistant to all medications.

March 10, 2015