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Suggest Treatment For Depression And Recurrent Migraine Headaches
Question: Hi
My daughter 44 years old and has suffered with migrane headaches since she was 7 years of age. She is very often taken to hospital where she doesn't really get much relief. She has a young family and needs to stay on top of things but over the years she has become depressed and not coping with life. Could you tell me if you think Endep 10 could help her or maybe a stronger version to start with then lowering the dosage along the way if it works.
I look forward to your reply
Many thanks XXXX
My daughter 44 years old and has suffered with migrane headaches since she was 7 years of age. She is very often taken to hospital where she doesn't really get much relief. She has a young family and needs to stay on top of things but over the years she has become depressed and not coping with life. Could you tell me if you think Endep 10 could help her or maybe a stronger version to start with then lowering the dosage along the way if it works.
I look forward to your reply
Many thanks XXXX
Brief Answer:
How about a change of perspective in order to gain CONTROL?
Detailed Answer:
Good morning. My name is Dr. Saghafi and I am an adult neurologist with a HEADACHE SUBSPECIALIZATION. I am sorry your daughter is in such straights for has been dealing with this problem for at least as 35 years. I actually have many patients with headaches for that length of time as well who never believed they could get better until they get recruited in our program that I advocate and teach in the clinic. Essentially, it involves going through a few very remedial yet extraordinarily important steps in order to gain control over the headaches, DE-EVOLVE them into an entity which no longer is the CENTERPIECE of the patient's life, figuring out what the name of the headache or headaches might be. And finally offering a specific and good headache course of treatment demonstrating that we UNDERSTAND exactly what kinds of headaches she has (by medical terminology NAME) which then, directs us to the type of treatment that may be good to try, etc. This may seem to be a tedious process but I never prescribe or suggest medications or other interventions to anybody who does not have a diagnosis YET. Make sense?
As far as telling you whether or not ENDEP 10 is good or not I think the medication is a good choice SO LONG AS YOUR DAUGHTER HAS A CERTAIN CLASS OF HEADACHE AND SO LONG AS THE ONLY THING BEING SOUGHT AFTER AT THIS TIME IS PROPHYLAXIS. ENDEP 10 will not be useful in the event she has a severe and debilitating headache such as a migraine or hemicranial paroxysm in which case she will likely require something else as an abortive drug. The other thing is that ENDEP 10 should be slowly titrated upward (once the headache type is verified by use of her logs) for effect. Now, in the US we have another similar type of drug to ENDEP which is one of my favorites which goes by the name NORTRIPTYLINE. That has less side effects than ENDEP and therefore, should attract your attention a bit. It's dosed identically upwards on a weekly.
Please hang onto the following web address as you can use it for sending more questions to me in the future: bit.ly/drdariushsaghafi
I would be honored to answer you quickly and comprehensively.
Please keep me informed as to the outcome of your situation.
The query has required a total of 56 minutes of physician specific time to read, research, and compile a return envoy to the patient.
How about a change of perspective in order to gain CONTROL?
Detailed Answer:
Good morning. My name is Dr. Saghafi and I am an adult neurologist with a HEADACHE SUBSPECIALIZATION. I am sorry your daughter is in such straights for has been dealing with this problem for at least as 35 years. I actually have many patients with headaches for that length of time as well who never believed they could get better until they get recruited in our program that I advocate and teach in the clinic. Essentially, it involves going through a few very remedial yet extraordinarily important steps in order to gain control over the headaches, DE-EVOLVE them into an entity which no longer is the CENTERPIECE of the patient's life, figuring out what the name of the headache or headaches might be. And finally offering a specific and good headache course of treatment demonstrating that we UNDERSTAND exactly what kinds of headaches she has (by medical terminology NAME) which then, directs us to the type of treatment that may be good to try, etc. This may seem to be a tedious process but I never prescribe or suggest medications or other interventions to anybody who does not have a diagnosis YET. Make sense?
As far as telling you whether or not ENDEP 10 is good or not I think the medication is a good choice SO LONG AS YOUR DAUGHTER HAS A CERTAIN CLASS OF HEADACHE AND SO LONG AS THE ONLY THING BEING SOUGHT AFTER AT THIS TIME IS PROPHYLAXIS. ENDEP 10 will not be useful in the event she has a severe and debilitating headache such as a migraine or hemicranial paroxysm in which case she will likely require something else as an abortive drug. The other thing is that ENDEP 10 should be slowly titrated upward (once the headache type is verified by use of her logs) for effect. Now, in the US we have another similar type of drug to ENDEP which is one of my favorites which goes by the name NORTRIPTYLINE. That has less side effects than ENDEP and therefore, should attract your attention a bit. It's dosed identically upwards on a weekly.
Please hang onto the following web address as you can use it for sending more questions to me in the future: bit.ly/drdariushsaghafi
I would be honored to answer you quickly and comprehensively.
Please keep me informed as to the outcome of your situation.
The query has required a total of 56 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi again
Sorry I didn't mention she suffers with Cluster Headaches lasting 3 to 4 days. She is in hospital at the moment with one. Does this help you to suggest anything. We are in Australia, she has had many neurologist but no success.
Thanks XXXXXXX
Sorry I didn't mention she suffers with Cluster Headaches lasting 3 to 4 days. She is in hospital at the moment with one. Does this help you to suggest anything. We are in Australia, she has had many neurologist but no success.
Thanks XXXXXXX
Brief Answer:
Better to tell me the symptoms of her headaches and what's been tried
Detailed Answer:
I believe it would be much more useful if you tell me exactly what her symptoms are for which the diagnosis of CLUSTER HEADACHE has been made. Just on an informational note, cluster headaches are quite a bit less frequent in women in compared to men and especially at her age.
Therefore, my first question is how secure is the diagnosis. The 2nd question I have is to list the medications OR INTERVENTIONS AND protocols which have been tried specifically to treat her cluster headaches. What diagnostic tests have been performed to be sure that there is not something else causing her symptoms.
The 3rd question is whether or not your daughter has been seen by a HEADACHE SPECIALIST or just the several neurologists you mention. What is your impression as to why the doctors have not had success with her?
The query has required a total of 66 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Better to tell me the symptoms of her headaches and what's been tried
Detailed Answer:
I believe it would be much more useful if you tell me exactly what her symptoms are for which the diagnosis of CLUSTER HEADACHE has been made. Just on an informational note, cluster headaches are quite a bit less frequent in women in compared to men and especially at her age.
Therefore, my first question is how secure is the diagnosis. The 2nd question I have is to list the medications OR INTERVENTIONS AND protocols which have been tried specifically to treat her cluster headaches. What diagnostic tests have been performed to be sure that there is not something else causing her symptoms.
The 3rd question is whether or not your daughter has been seen by a HEADACHE SPECIALIST or just the several neurologists you mention. What is your impression as to why the doctors have not had success with her?
The query has required a total of 66 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your reply. My sister has now gone home. She is the mother of XXXXXXX the 44 year old Cluster headache girl. I will forward all this information on to her other daughter as my sister doesn't have a computer and I am unable to answer all your questions. I hope this is alright with you. The e-mail address to send any future correspondence is: YYYY@YYYY
Thank you XXXX
Thank you XXXX
Brief Answer:
Thank you for the information and your email address
Detailed Answer:
Thank you for letting me know that your sister will be receiving the information. If she doesn't have a computer then, perhaps you'd agree (as Mandy's aunt?) to help relay the answers to some of these questions through your system? Or would that be the job of your other niece? I hope XXXXXXX gets the attention she needs. Cluster headaches are not as common in women as they are in men and they are difficult to treat no matter which gender one is referring to treating. Nevertheless, I believe your niece should be able to get adequate treatment. But the first step as far as I would be concerned is to be sure we have the right diagnosis. Hence, the questions.
Since this is the final question in this series would you be kind enough to CLOSE THE QUERY on your end? A HIGH STAR RATING with some written feedback on your satisfaction with this conversation would be greatly appreciated and please pass on the following web address to either your niece or sister which they can use when contacting me for further assistance:
bit.ly/drdariushsaghafi
Cheers!
The query has required a total of 93 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Thank you for the information and your email address
Detailed Answer:
Thank you for letting me know that your sister will be receiving the information. If she doesn't have a computer then, perhaps you'd agree (as Mandy's aunt?) to help relay the answers to some of these questions through your system? Or would that be the job of your other niece? I hope XXXXXXX gets the attention she needs. Cluster headaches are not as common in women as they are in men and they are difficult to treat no matter which gender one is referring to treating. Nevertheless, I believe your niece should be able to get adequate treatment. But the first step as far as I would be concerned is to be sure we have the right diagnosis. Hence, the questions.
Since this is the final question in this series would you be kind enough to CLOSE THE QUERY on your end? A HIGH STAR RATING with some written feedback on your satisfaction with this conversation would be greatly appreciated and please pass on the following web address to either your niece or sister which they can use when contacting me for further assistance:
bit.ly/drdariushsaghafi
Cheers!
The query has required a total of 93 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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