Post Concussion Syndrome Help

I had a second concussion in November 2007 (the first was in 2005).  My doctor said I have post concussion syndrome. I hit my head on the front right side the first time and on the back of my head the second time.  It is now March 2008 and I am experiencing a continual feeling of pressure and frequent sharp pains in the right temple area.  I had a CT scan that came back normal.  The head aches seem to get worse with moderate exercise, although walking is okay.  I am a cyclist and would like to return to riding.  The doctor said I might consider Nortriptyline - but I am not experiencing depression and am unsure why this would be considered. I saw a 2006 article about post concussion syndrome and regulated exercise, but have found nothing else on this topic.  Any suggestions?  I would very much like to return to exercise.

[perennialgardener]

In 2004 I was rear-ended by a drunk driver going about 55 mph while I was stopped.  I've been referred to a number of doctors, including neurologists, pain specialists and neurophychogists at a teaching hospital.  I was having daily migraines and muscle spasms in my neck that were so bad I could not turn my head.   Eventually I was referred to a neurologist who specializes in headaches.  I've been on a number of "pain packages", which usually include antidepressants, antiseizure meds, muscle relaxants, and most recently even a blood pressure med.

Of all of the combinations of medications, none worked until amipryptaline was added to the mix.  It's in the same class as nortryptaline.  I read that the combination of baclafen (a muscle relaxant) and amitryptaline (antidepressant) are specific for the treatment of pain secondary to head trauma.  

My understanding is that it enhances the body's use of seratonin and norepinephrine.  These two substances are needed for our normal sleep cycle, pain control, and mood.  My treating neuropsychologist explained to me that when your body is in pain crisis, you will usually have a shortage of these substances.

I'd certainly give it a try.