A REVIEW OF THE TREATMENT OF PRIMARY HEADACHES - PART-II - TENSION-TYPE HEADACHE

This paper reviews pharmacological and other approaches currently used to treat tension-type headache (TTH), and examines aspects of the cla ssification and pathogenesis of this common complaint. Accurate diagno sis is essential before treatment is prescribed and should involve com plete history taking, thorough neurological examination and evaluation of possible associated factors. The most frequently used drugs for th e acute treatment of TTH are non-steroidal anti-inflammatory drugs (NS AIDs) of which only some have been shown to be efficacious in placebo- controlled trials. Amitriptyline remains the first choice treatment fo r prophylaxis. Other antidepressants, muscle relaxants and benzodiazep ines may be used, but few have been evaluated adequately in placebo-co ntrolled trials. Biofeedback and relaxation training, demonstrated eff icacious by controlled studies, may be used when the aim is to avoid t he side effects of pharmacological treatment.