Use of tranqulizers for refractory migraine headaches

Anxiety and depression occur in migraine patients 2 to 3 times more often than in those without headaches.  The opposite is also true, those with anxiety and depression are more likely to develop migraines.  Certain antidepressants, such as amitriptyline (Elavil), nortriptyline (Pamelor), venlafaxine (Effexor), and duloxetine (Cymbalta) have been shown to help prevent headaches.  However, when an antidepressant (or any other drug) is being tested for the prevention of headaches, patients with depression and anxiety are usually excluded.  This is done to clearly establish if a drug works to prevent headaches directly, rather than indirectly through relieving anxiety and depression.  There have been no studies of drugs to treat people who have both conditions.  A report by Dr. Morris Meizels published in the current issue of Headache presents cases of three patients with severe migraines and anxiety who did not respond to the usual preventive medications.  They did respond very well when he prescribed clonazepam (Klonopin), which is a tranquilizer in the family of benzodiazepines.  Diazepam (Valium) and alprazolam (Xanax) are two other well-known members of that family, but they all have somewhat different clinical properties.  Dr. Meizels stresses the fact that these drugs are potentially addictive and habituating and should be used in carefully selected patients and under close supervision.

  1. Dr. Mauskop says: 06/05/20107:07 pm

    Klonopin and similar drugs have never been shown to cause rebound headaches and, in fact can help. Here is the link to the article mentioned in my post above

  2. Bobby G. says: 06/05/20105:59 am

    I’m not sure where to look, as I’ve seen many articles. I now have new doctors who are telling me that klonopin is causing rebound headaches, migraines, etc:. I’m agoraphobic and its the only drug that lets me be like I was before the panic attacks and nervousness started. There trying to get me to stop taking it and go without nothing. I don’t really want to be stuck in my home looking out the window. Anyone that could point me to a website or med. article would be very helpful. From what I have read so far klonopin hasn’t been a factor, I’ve been taking it since 96′ and just recently (last 2 yrs) have started having these headaches varying from just heavy pain to attacks that leave me with pain, unable to speak, numb left side.

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