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Neurology (Expert Forum)
Chronic Daily Headache with Migraine
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Chronic Daily Headache with Migraine
by SteveH, May 08, 2006 12:00AM
Dear Sirs, We have a 15-1/2 year old daughter who has now had a continuous migraine since Feb 22, 2003. She is light sensitive and sound sensitive, and when she gets too much of either, her headache gets worse and then she becomes nauseated and dizzy. Her headache is 24/7, never below an 8 on her pain scale, and goes up to a 10, 2 to 3 times a month. We have to home school her to control her environment. She has been treated at the Diamond Headache clinic, inpatient unit for 3 weeks, and 1.5 years as an out patient. After 36 different medicines, not one moved, budged, or lowered her headache. Typically the medicines only made it worse, especially when she took any SSRI's. She is currently on no medicines. Her younger sister who is 11, was recently placed on Zoloft to try and treat some OCD behaviors. When she hit 75 mg, she complained of a constant headache. Even 6 weeks off, the medicine, she still had a headache. She has not been off it for 12 weeks and her daily headache is gone. Thank God. My question is "Can too much Serotonin cause chronic daily headache?" I tried researching this but found nothing. Is there a drug that reduces serotonin?
Doctor's Answer
by CCF-Neuro-M.D.-PW, May 16, 2006 12:00AM
There is a syndrome of serotonin toxicity called serotonin syndrome, usually seen with interaction between medications that promote the serotonin system. Isolated headache though is not a feature of the syndrome - it usually causes confusion, euphoria, muscle spasms etc. SSRI are probably not the primary cause of her headache
THere is no drug that reduces serotonin in the same way that SSRIs increase it over time. Some of the triptan migraine medications are serotonin antaganists at various different types of drug receptors, but are only used in teh acute rather than chronic setting.
Medications alone are usually not enough to break these headaches. One must be on a multidisciplinary program involving headache psychology, physical therapy for the neck (a common trigger of headache), medications, biofeedback, trigger point injections etc. Perhaps a second opinion at another headache center with all of these facets of treatment would help.
Goodluck
THere is no drug that reduces serotonin in the same way that SSRIs increase it over time. Some of the triptan migraine medications are serotonin antaganists at various different types of drug receptors, but are only used in teh acute rather than chronic setting.
Medications alone are usually not enough to break these headaches. One must be on a multidisciplinary program involving headache psychology, physical therapy for the neck (a common trigger of headache), medications, biofeedback, trigger point injections etc. Perhaps a second opinion at another headache center with all of these facets of treatment would help.
Goodluck
Anyone know why using an SSRI would increase the headache in her as well as cause a headache in her sister?
BTW, did your daughter's doctor mention the possibility of pseudotumor cerebri? It usually is found in young women (usually who are overweight) and can manifest with headaches and vision problems.