Epilepsy Drug May Reduce Daily Headaches
But Experts Say Neurontin Is Not a Top Choice
Caffeine and Decongestants
Neurologist and headache specialist David Buchholz, MD, says some of the biggest headache-causing culprits include over-the-counter analgesics containing caffeine and decongestants in over-the-counter sinus drugs.
"These decongestant-containing drugs are a huge problem because so many people have headaches that they incorrectly attribute to sinus problems," he says.
He adds that narcotics and many other prescription drugs used to treat chronic headaches can also cause problems. Buchholz is an associate professor of neurology at Baltimore's Johns Hopkins Medical Institutions and has just published a book called Heal Your Headache.
Both experts say they consider Neurontin one of the least effective medications used to prevent chronic daily headaches. Silberstein had conducted prevention studies on the epilepsy drug Topamax. He considers this drug, along with the epilepsy drug Depakote and certain tricyclic antidepressants, to be the most effective prevention drugs available.
Buchholz says calcium-channel blockers can also help prevent headaches in certain patients.
The two experts disagree about the importance of foods as headache triggers. Buchholz says that a long list of foods -- including caffeine, chocolate, cheeses, nuts, MSG, alcohol, and even bananas and citrus fruits -- can bring on headaches, and he urges his patients to avoid them. Silberstein says that with the exception of alcohol, MSG, and caffeine, there is no scientific evidence linking foods with headaches.
"It is draconian to impose a long list of food restrictions on headache patients without scientific evidence to back it up," Silberstein says.