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Suggest Treatment For Persistent Mild Headache With Nausea

Posted on Thu, 14 Jul 2016

Question: I am having headache for the last 1 and half year. Most of the time location of the headache is top center. It is normally mild, but at times gets severe. But I suffer from headache almost daily.

Answered by Dr. Neeraj Kumar (1 hour later)

Brief Answer:
Take treatment as advised.

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
Is there any associated nausea, vomiting, sensitivity to light or sound?
Headache seems to be of numular type may be associated with tension.
You can start amitryptiline or sertraline, these medicines are available on prescription by a doctor.
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Neeraj Kumar (17 hours later)

Thanks for your quick response. Sincerely appreciate. I have gone through the prescriptions given by my Neurologist and wish to inform that following was the complete list of medicines given to me.

1. Amitone 10 mg (daily at night) : This medicine has the same salt, i.e. Amitryptiline as prescribed by you.
2. Szetab 10 mg (daily at night)
3. Sibelium 10 mg (daily at night)
4. Valance OD 500 (daily at night)
5. Superia DSR (daily in the morng)
6. Sumo (SOS)

I took the above treatment for 2 months. Though initially there was some relief, but subsequently I realized that there is not much change and I had to take pain killers quite often.

I stopped the above treatment one month back since I was feeling too sleepy even during the day and my blood pressure dropped (60-70/100) even after stopping Telma 40. Also not much relief was there to my headache. My blood pressure XXXXXXX after stopping the above treatment and I have restarted Telma 40.

I am not having any feeling of vomiting or nausea. In view of the above details, please advise the treatment, i.e. name of medicines, their strength and dosage. Shall be grateful for your valuable advise. Regards...Sunil Babbar

Answered by Dr. Neeraj Kumar (12 hours later)

Brief Answer:
Take treatment as advised

Detailed Answer:
Hello,
You are being given medication for migraine and tension type headache.
Regular pain killers lead to medication overuse headache.
You should again start treatment under a neurologist guidance as effects of drug is gradual.
Amitryptiline or nortryptiline can be started.
Gradual dose increase will prevent drug related side effects.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Neeraj Kumar (11 hours later)

Thanks for your response Dr. XXXXXXX I would request you to please prescribe the medicines, i.e. name of the drug, its strength, dosage and the period for which it has to be taken. You would please appreciate that it may work out if tell a Neurologist to prescribe the medicine for my ailment based on the salts (Amitryptiline or nortryptiline) prescribed by you. As such I have already consulted two leading Neurologists - 1. Dr. XXXXXXX Garg, Neurologist (HoD Fortis) and 2. Dr. Jaideep Bansal, Neurologist (HoD Maharaja Agrasen Hospital). They prescribe a lot of medicines, but so far not much has been achieved to cure my ailment. I stay in XXXXXXX North of XXXXXXX If you are based in XXXXXXX I can meet you personally.

Kindly advise and help. Regards.

Answered by Dr. Neeraj Kumar (7 hours later)

Brief Answer:
Take treatment as advised and follow up

Detailed Answer:
Hello,
You can start with Tryptomer 10 mg at night which can be increased to 25 mg after 2 weeks if sedation is not a problem.
Take beta blockers, propranolol 20 mg instead of telma as it will be helpful for blood pressure, anxiety and headache too. Propranolol ( Betacap TR) can be increased after 2 weeks to 40 mg single dose.
Take pain killers like Naproxen or Aceclofenac as needed but at minimal possible frequency. You can the following medications described above by doctor's prescription.
Take timely food, rest, timely sleep.
Avoid loud noise and bright lights.
Put a direct premium question on my name after around three weeks of treatment.
Monitor pulse rate as propranolol can cause decreased heart rate.
Wishing you good health and early recovery.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar