Your doctor may prescribe medicine to both treat and prevent tension headaches. He or she may first suggest you try a nonprescription drug, which usually has fewer side effects than prescription drugs. The type of tension headache that you have may help your doctor determine which drug to prescribe. You may have to try several different drugs or types of drugs before you find the one that is right for you. Good communication with your doctor is important in finding the most effective treatment for you.

Medication Choices

Medicines you may be given to treat or prevent tension headaches include:

• Antidepressants such as mirtazapine (Remeron) and the tricyclic antidepressant amitriptyline. When taken daily, these medicines can help reduce how often tension headaches occur and how long they last.¹
• Seizure medicines or antianxiety drugs. These medicines are not often used to treat tension headaches.

In some cases your doctor may prescribe drugs such as barbiturates or narcotics when other drugs are ineffective. But these drugs can be habit-forming and should be used sparingly.

Should I take prescription drugs for tension headaches?

Botulinum toxin type A (BTX-A) is sometimes injected into the muscles in the face and head, to reduce contractions or spasms that in the past were thought to produce tension headaches. But BTX-A injections do not seem to help with symptoms of tension headaches.¹ And BTX-A may cause weakness of the facial muscles and may affect swallowing.

What To Think About

Try to avoid taking nonprescription drugs more than 3 times a week because you may get rebound headaches. Rebound headaches are different from tension headaches. They are usually triggered after pain medicine has worn off, prompting you to take another dose. Eventually, you get a headache whenever you stop taking the medicine.

Certain pain medicines interact poorly with other medicines. Before you begin taking pain medicines, be sure to let your doctor know about all of the drugs-both prescription and nonprescription, and other complementary therapies (such as herbs)-that you are taking.