Medication Usage Patterns for Headache Treatment After Mild Traumatic Brain Injury

Abstract

Headaches after mild TBI are frequent and are not optimally treated. Results suggest that many individuals with mild TBI may be self-treating their headaches by utilizing over-the-counter pain relief medications. These medications, however, are only providing effective treatment for a minority of this population. Further research must be conducted to develop evidence-guided treatment and educate providers.

Left Dorsolateral Prefrontal Cortex rTMS in Alleviating MTBI Related Headaches and Depressive Symptoms

“…This debilitating condition is unfortunately often accompanied by neuropsychological dysfunction in mood, attention, and memory, which casts a profound negative impact on patients' quality of life. Both prescribed and over‐the‐counter medications provide limited efficacy in managing the headaches in a minority of this patient population . Conversely, these medications often carry untoward psychosomatic and abusive side effects .…”

“…Both prescribed and over‐the‐counter medications provide limited efficacy in managing the headaches in a minority of this patient population . Conversely, these medications often carry untoward psychosomatic and abusive side effects . Therefore, developing and validating nonpharmaceutical and noninvasive neuromodulatory means of headache intervention has been one of the highly prioritized focuses in managing MTBI‐HA.…”

Traumatic brain injuries

“…In PCS cases with persistent symptoms, headaches persisting >3 months, especially the migraine type, may respond to medication 186 . Depression is common secondary to complicated mild TBI 187 , and can be treated by a combination of medication and behavioral approaches.…”

Post-Traumatic Headache

“…102 Expert opinion has suggested treating PTH according to its clinical characteristics using the primary headache disorder classification criteria. 24,103,104 Based on the close phenotypic similarity of PTH to primary headaches, one approach to treatment decisions is to use primary headache characterization of the PTH as migraine, probable migraine, tension-type headache, or other primary disorder.…”

“…Few epidemiologic data are available on the extent of this problem. Although it is extremely important to recognize the possibility of MOH, especially given the high rate of use of OTC products by those who have sustained a TBI, 102 it is important to examine the development of persistent headache and associated medication use and consider changing or withdrawing suspected medication before concluding that PTH is worsened or prolonged because of medication overuse. Education regarding medication overuse is key, and the assistance of a diary or other record of medication use is important.…”