hEALTH

PAIN

Tense Headache

Tension-type headache - old and new drugs

Episodic and chronic tension-type headache is the most nonspecific and one of the most frequent headache: about 80 % of American people suffer from this pain in the forehead area. However, researcher as well as the pharmaceutical industry are more interested in investigating migraine. As a result, there are few well-designed studies on the pharmacotherapy of tension-type headaches. These support the use of age-old standard drug classes, the tricyclic antidepressants and the nonsteroidal anti-inflammatory drugs. In addition, medication-overuse headache (MOH) has increasingly become a focus within the field of headache, and temporomandibular joint dysfunction (TMD) is likely an underdiagnosed cause of chronic headaches and facial pain.
Recently, botulinum toxin type A and nitric synthase inhibitors were applied successfully for the treatment of tense headache. In the case of botulinum, a toxin of the bacterium Clostridium botulinum, small amounts of the toxin were injected into the forehead area, providing relief to patients. Further research is yet needed to analyze these substances and others as potential drugs against tension-type headache.

Chronic headaches: pharmacological and non-pharmacological treatment.
Grazzi L, Usai S, Bussone G.
Neurol Sci. 28 Suppl 2:S134-7 (2007).

Temporomandibular dysfunction: an often overlooked cause of chronic headaches.
Lupoli TA, Lockey RF.
Ann Allergy Asthma Immunol. 99:314-8 (2007).

Medication-overuse headache: description, treatment, and relapse prevention.
Grazzi L, Andrasik F.
Curr Pain Headache Rep. 10:71-7 (2006).

Preventative treatment for migraine and tension-type headaches: do drugs having effects on muscle spasm and tone have a role?
Freitag FG.
CNS Drugs 17: 373-81 (2003).

Pharmacotherapy of tension-type headaches.
Stillman MJ.
Curr Pain Headache Rep. 6: 408-13 (2002).

The Use of Botulinum Toxin Type A in Headache Treatment.
Mathew NT, Kaup AO.
Curr Treat Options Neurol. 4: 365-373 (2002).

Use of botulinum toxins for chronic headaches: a focused review.
Loder E, Biondi D.
Clin J Pain. 18 (6 Suppl): S169-76 (2002).

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