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Are there any prescription treatments for tension headaches?

Prescription strength doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (brand name Motrin), >naproxen (Naprosyn), and >ketoprofen (Orudis) are the primary treatments for tension headaches that don't respond to over-the-counter drugs. These drugs are effective in up to 70 percent of people and start to relieve headache pain within 15 to 30 minutes.

Doctors may prescribe combination drugs that contain butalbital, caffeine, and either aspirin or acetaminophen (>Fiorinal or >Fioricet) if NSAIDs aren't effective. These combination medicines may work better for some people but can cause physical dependence if used on a regular basis. They relieve headaches within 15 to 30 minutes.

>Diazepam (Valium), >baclofen (Lioresal), and >cyclobenzaprine (Flexeril) are muscle relaxants that help some people when pain relievers alone do not relieve headaches. But there is little evidence to show that muscle relaxants are an effective treatment.

Doctors may prescribe antidepressant medicines such as >amitriptyline (Elavil), >nortriptyline (Pamelor), or >fluoxetine (Prozac) to prevent tension headaches that are severe or occur frequently. Up to 65 percent of people respond to these medicines, reducing the number of headaches by 25 to 50 percent. You take these medicines for preventive purposes on a daily basis.

Sources:
Johns Hopkins Symptoms and Remedies. Medletter Associates Inc., 1999.
Mayo Clinic Family Health Book. William Morrow & Co., 1996.
The Merck Manual of Medical Information: Home Edition. Merck & Co., 1997.
Silberstein, S.D., R.B.Lipton, and P.J. Goadsby. Headache in Clinical Practice. Isis Medical Media, 1998.
Applied Therapeutics: The Clinical Use of Drugs. Applied Therapeutics, 1995.

This answer prepared 12/13/00.

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