New York Headache blog

Droperidol (Inapsine) is not a phenothiazine, but is structurally very similar to this class of anti-nausea and anti-psychotic drugs. It also has similar properties of relieving nausea and being a major tranquilizer. And just like phenothiazines...

Doxepin (Sinequan) is a tricyclic antidepressant and all drugs in this category (amitriptyline, nortriptyline, desipramine, protriptyline) appear to be effective for the prevention of migraine headaches. Only a single small trial...

Domperidone (Motilium) is not a champagne (that would be Dom Perignon and it can give you a headache) but an excellent nausea medication which is often used for the treatment of nausea associated with migraines. It is available...

Divalproex sodium (Depakote) is one of two epilepsy drugs that are also approved by the FDA for the preventive treatment of migraine headaches (the other one is topiramate, or Topamax). It was approved by the FDA in 1983 to treat...

Dihydroergotamine (DHE-45) when given intravenously (IV) is considered to be the most effective migraine medication. It was introduced in 1943 and has been the go-to drug for migraines that do not respond to other medications. We usually...

Diclofenac (Cambia, Voltaren) is one of the nonsteroidal anti-inflammatory drugs (NSAIDs) used for the treatment of migraine headaches. Cambia, which contains 50 mg of powdered diclofenac, is specifically approved by the...

Dichloralphenazone is one of three ingredients in the headache drug, Midrin. The other two ingredients are isometheptene, a drug that constricts blood vessels and acetaminophen. Midrin actually is a combination of...

Desvenlafaxine (Pristiq) is an antidepressant in the family of serotonin and norepinephrine reuptake inhibitors (SNRIs). Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and escitalopram...

Desipramine (Norpramin) belongs to the family of tricyclic antidepressants which have been proven to be effective for the treatment of various pain syndromes and for the prevention of migraine headaches. Desipramine is used...

Celecoxib (Celebrex) is a non-steroidal anti-inflammatory drug (NSAID) that belongs to a subclass of selective COX-2 inhibitors. This subclass of drugs tends to be safer on the stomach compared to aspirin, naproxen (Aleve), ibuprofen...

We’ve been prescribing medical marijuana for migraines and other painful conditions since it was legalized in the state of New York four years ago. While it does not seem to help most of our patients, it does benefit a significant...

The FDA has just approved galcanezumab (Emgality), the third CGRP monoclonal antibody for the prophylactic treatment of migraines. It follows erenumab (Aimovig) and fremanezumab (Ajovy) and just like these two drugs it...

Bisoprolol (Zebeta) is one of about a dozen drugs in the beta-blocker family, medications that were developed for the treatment of high blood pressure, or hypertension. The oldest beta blocker, propranolol (Inderal) was approved...

A recent report by neurologists from the Mayo Clinic suggests that onabotulinumtoxinA (Botox) injections can relieve not only headache pain, but associated neurological symptoms, such as visual aura, numbness and weakness...

Fremanezumab (Ajovy) was just approved by the FDA for the preventive treatment of migraine headaches. It is the second drug, following erenumab (Aimovig), with a similar mechanism of action. While erenumab blocks calcitonin...

Bupivacaine (Marcaine, Sensorcaine) is a numbing agent (local anesthetic) similar to lidocaine (Xylocaine), but with a longer duration of effect. Bupivacaine effect lasts 4 to 8 hours, while lidocaine, only 2 hours. However, lidocaine...

Dexamethasone (Decadron) is a strong corticosteroid (steroid) anti-inflammatory medication similar to prednisone and methylprednisolone (Medrol). Considering that inflammation occurs during a migraine attack and that...

Codeine is a mild opioid (narcotic) pain killer, which has less of an addiction potential of butorphanol, described in the previous post, or most other opioid drugs. However, it definitely can cause addiction and can be a “gateway drug”...

Butorphanol nasal spray (Stadol NS) is approved by the FDA for the treatment of acute migraine attacks. It belongs to the agonist-antagonist type of opioid (narcotic) drugs, while morphine, methadone, oxycodone, and most other...

Injections of onabotulinumtoxinA (Botox) are approved for the treatment of chronic migraine headaches in adults. Botox is also widely used off-label (not an FDA-approved use) for the treatment of migraines in children. We know that...

Cyproheptadine (Periactin) is one of the most popular drugs for the prevention of migraine headaches in children. Unfortunately, there is only one scientific study suggesting that cyproheptadine (4 mg per day) is as...

Blood pressure medication propranolol was the first preventive drug approved for the treatment of migraine headaches over 50 years ago. It belongs to the family of beta blockers, but other types of blood pressure drugs can be...

Clonazepam (Klonopin) is a drug approved for the treatment of panic attacks and certain types of seizures. It is also used “off label” to treat anxiety, insomnia, and muscle spasm. Clonazepam belongs to the family of benzodiazepines...

Chlorpromazine (Thorazine) belongs to the phenothiazine family, which includes prochlorperazine (Compazine) and promethazine (Phenergan), drugs used to treat nausea and vomiting. These drugs can relieve not only...

Medical marijuana (MM) is now legal in 30 states. Most states approve its use for specific medical conditions and severe pain and nausea, which are symptoms of migraine, are usually on the list. I’ve been prescribing MM since...

Almost everyone has an occasional pain in the upper back and shoulders, often caused by prolonged sitting in front of a computer or just by stress. The pain is due to muscle spasm and keeping those muscles in good shape helps...

Candesartan (Atacand) is a blood pressure medication in the class of ACE receptor blockers (ARBs), none of which are approved for the treatment of migraines. Because they are available in a cheap generic form no pharmaceutical...

The New York Headache Center participated in a large (245 patients) placebo-controlled trial of butterbur, which showed that 150 mg of butterbur is effective in the prevention of migraine headaches when compared to placebo. The results were...

Caffeine can be considered a drug since it is available in a pure form in tablets and injections. It is also included in medications, such as Excedrin, Fioricet, and Fiorinal. It is considered to be an analgesic adjuvant, meaning that it...

Boswellia serrata is not a drug, but a plant, but I am including herbal products as well if a serious scientific journal has published articles on it. Most of the available information on Boswellia is in mentioned in my previous post. I would only...