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Chronic Tension-type Headaches and What to Be Aware of.
When patients begin to have chronic tension-type headaches more than 15 days a month, then it is necessary to avoid the medications mentioned in the acute treatment page. This is because overuse of any pain medication can lead to rebound headache where the pain medicine itself causes the headaches to continue. These headaches are the hardest headaches to treat. Critically important in these patients is to make sure the diagnosis is correct. Chronic migraine patients typically have a lot of tension type headaches. If their headaches are never more than moderate, than many patients believe they have tension type headaches. If their headaches are moderate and they have any additional symptom that is typical of migraine, then Dr. Loftus typically treats them as probable migraine
The most commonly used medications to treat chronic tension-type headaches are medications that target serotonin (5HT) and norepinephrine (NE). In animal models of pain in general, the more balanced, the better. The older tricyclic antidepressants called amitriptyline is the most balanced drug for 5HT and NE but has lots of side effects due to other receptors. Selective serotonin and norepinephrine re-uptake inhibitors, SNRIs are more selective. Dr. Loftus usually uses duloxetine as it is best studied across a variety of pain indications.
If a patient fails one of the above medications, then it is critically important in these patients is to make sure the diagnosis is correct. Chronic migraine patients typically have a lot of tension type headaches. If their headaches are never more than moderate, than many patients believe they have tension type headaches. If their headaches are moderate and they have any additional symptom that is typical of migraine, then Dr. Loftus typically treats them as probable migraine
Another medication, tizanidine, has also been shown beneficial for this type of headache.
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Liana R.(Patient Since 2012)
I was more than pleased with my whole experience. I felt like Dr. Loftus genuinely cared for me and wanted to do everything he could to help me with my headaches. I will not be going back to my other neurologist who I have been going to for the last 6 years after seeing how professional and helpful the Bellaire Neurology office was to me.
Sherry H.(Patient Since 2018)
Dr Loftus is thorough and knowlegeable. He will not give up on finding a way to help.
Providing headache and hyperhidrosis care & wellness for over 25 years.
Dr. Brian Loftus, M.D.
Dr. Loftus is Board Certified in Headache Medicine as well as Neurology. In private practice since 1994, Dr. Loftus’ practice has gotten busier and he has decided to concentrate his practice in areas that he can make a particular difference compared to other neurologist. Therefore, Dr. Loftus has chosen to focus his neurology practice on headaches & head pain, headaches during pregnancy, and hyperhidrosis. In the spring of 2006, Dr. Loftus relocated his practice from the Texas Medical Center to Bellaire, just 5 miles west. He has been named a Texas Monthly “Super Doctor” and an H Texas magazine “Top Doctor” multiple times.