Revisiting pediatric migraine: preventive medications, part 1

In this post, I revisit the prescribing a daily medication for migraine prophylaxis, the standard medications for those under age 18. I use one migraine/week as a benchmark for considering a daily preventive medication. Here’s some good information on the basic daily medications that pediatric primary care providers could start for their patients with frequent … Continue reading Revisiting pediatric migraine: preventive medications, part 1

Revisiting migraine: supplements

Primary preventive measures to reduce migraine, such as the healthy headache lifestyle, are key to keeping migraine frequency to a minimum. But even though your patient is really working hard with the multidisciplinary approach, your patient is still having frequent migraines which significantly impact their functioning.  When do you consider adding a daily medication to … Continue reading Revisiting migraine: supplements

Revisiting migraines part 4: adjuvant medications and combination therapies

My last posts have focused on migraine abortives and analgesia for kids with migraine. Here I will continue to review medications and strategies for rescue, focusing on adjuvants and combination medications. These medications are the 3rd leg of the plan which are used to treat migraine. .  There are several medications that are used either … Continue reading Revisiting migraines part 4: adjuvant medications and combination therapies

Autonomic Nervous System Sensitivity

Mild dysfunction in the autonomic nervous system (ANS), also called mild dysautonomia is commonly comorbid with all primary headaches (migraine, TTH, NDPH). The ANS controls those body functions that we consciously have no control over, such as breathing, blood pressure regulation, heart rate regulation, digestion/GI motility, temperature regulation, sweating, or nervous system over-stimulation.  Common causes … Continue reading Autonomic Nervous System Sensitivity

Headaches and psychiatric co-morbidities, part 2

In part 1 of this post, pain and psychiatric issues often travel together. Chronic headache pain can lead to long-lasting psychological distress, and depression and anxiety increase the perception of both acute and chronic pain. They are intimately connected. This post will continue the discussion about psychiatric co-morbidities and headache, focusing on psychopharmacology. What is … Continue reading Headaches and psychiatric co-morbidities, part 2