What treatment is effective for chronic headaches?

Over 20 years, what has been tried, both unsuccessfully and with a little success? I presume nothing has brought an amount of success you find satisfactory. What evaluations have been done? Do u know the interpretations?

full blood work ups; mri; ct; usual background evaluations . . . nothing unusual found.

have tried four or five months each of Nurtec, Qlipta, Brintellix, Lyrica, cbd, etc.

I can reduce the pain significantly by taking Rokacet (paracetamol/caffeine/codeine) along with aspirin, but I need to take it every 4-6 hours.

Nothing works for me and I have had every medicine and procedure there is. 6 yrs/4 mos now with headache/dizziness that no doc can figure out. Can't drive or do much of anything.

Vyepti Infusion seems to be the only thing that has made any differences for me. Pain level 8 down to 4 (within 45 minutes) and slowly creeped up to a 6. Have to wait 3 months between infusion. After 3 infusions at 100mg, Neurologist said it can be upped to 300mg / infusion (insurance thing).

Things tried
- MRI with Imaging of Head and Neck.
- Topiramate 50mg to 100mg 2x/ day (brain fog so Neurology stopped - I kind of liked it)
- Propranolol 30mg 3x/day (I passed out due to low blood pressure so Neurology stopped. I had low blood pressure before starting)
- Emgality 120MG INJ (monthly - no effect on me)
- Ajovy 225MG INJ (monthly - no effect on me)
- Ketorolac Trometha 10MG (pain level 8 to 5 while taking)
- Migraine Infusion (#1) - lasted 3 days - Very Strong - Benadryl; Ketorolac (Toradol); Magnesium Sulfate; NaCI 0.9%; Prochlorperazine (Compazine); Methylprednisolone 4MG
- traMADol Hydrochlo 50MG Tab (pain level 8 to 5 while taking)
- Migraine Infusion IV (#2) - little effect - Very Strong - Acetaminophen (Ofirmev); dihydroergotamine (D.H.E. 45); Benadryl; Ketorolac (Toradol); methylPREDNISolone Sodium Succinate (Solu-Medrol); Metoclopramide (Reglan); NaCI 0.9%
- Eletriptan Hydrobr 40MG - Helps - I take it when migraine wakes me up at 2am to get back to sleep. Can only take every 4 days. Neurologist started on two other "Triptans".

For sinus infection, was on antibiotics and they seem to lower 24x7 headache / migraine pain level.
- Amoxi-Clav 875-125MG 14 Days
- predniSONE 10MG 12 Days

After going through this for the past year, Neurologist gave referral to Immunologist. That will be next year.

Everyone is unique.

🍀

Have you gone to one of the major headache centers like Mayo or Cleveland Clinic?

I live in Israel, but I did go to our headache center . . . that's where I got all those various ssri and other drugs that didn't work.

@jrsjc - welcome to Mayo Clinic Connect. The discussion you started is now part of the larger support group called Headache & Migraine, https://connect.mayoclinic.org/group/headache-migraine/. You might check out this link to see all the discussions in this group, some of which may relate to your situation.

Wondering if when you saw a doctor at your local headache center in Israel, if this is what they diagnosed you with? The treatments seem to potentially fall in line with the ones you mentioned you were prescribed.

- Chronic daily headaches https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/diagnosis-treatment/drc-20370897

Do you have symptoms in addition to head pain? If so, will you share more about those?

@jrsjc
I have not.

Well, I actually have multiple problems that seem to be intertwined: chronic headaches for DECADES - but NOT migraines, not cluster headaches. May possibly be initially related to hard parachute landing falls (PLFs) as I was in the paratroops (U.S.) from the age of 17 (but I don't recall any particularly bad PLFs throughout my life -- never hit my head -- I last jumped here [#87] with the IDF at about 70 y.o., nine years ago).

I have had a few cervical spine surgeries and a lumbar surgery for "slipped discs" over the years - causes unknown (maybe martial arts training?). If my neck starts to get stiff that will trigger headaches unless I "catch" it with a couple of diazepam (Valium) 10mg at the start. This is infrequent.

Another trigger is a sinus condition also of unknown origin (not any allergy) -- if I get really stuffed up it will give me a headache for which I take diphenhydramine (Benadryl). But mostly the majority of headaches seem to be idiopathic "tension headaches" -- again, unknown cause as I'm never tense about anything . . . I'm the most easy going person on planet earth and don't particularly worry about anything at all. I live a quiet life, mostly at home with a loving wife.

I can't point to any foods as a trigger.

My headaches are painful (sometimes VERY painful) but I can drive, think, watch TV, read, etc. even with them. They do make it difficult for me to do complex math (statistics -- I have a PhD) at times.

Sometimes I just take two Rokacet (paracetamol/caffeine/codiene)+ two 500 mg aspirin and go to sleep for a couple of hours.

I've seen my GP, a neurologist, and THE HEAD NEUROLOGIST at the pain clinic here. Had acupuncture, biofeedback, all kinds of anticonvulsants, SSRIs, and other analgesic meds. **I won't take any opioids other than the very small amount of codeine in Rokacet.** Still get daily headaches.

SUGGESTIONS???

@rickphd you might ask your doctor about adding a low dose of compazine. It doesn’t tend to help headaches by itself but can add to the benefits when taken with something that helps partially. It’s more effective for migraine headaches, but can at least be tried .