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Suggest Treatment For Headaches
Question: I have been suffering from chronic head aches (in and around both temples) for several years. Sometimes this pain increases a lot especially if I am stressed, depressed, anxious etc
I want to take second opinion regarding the medicines prescribed to me especially in view of my medical history.
Would you suggest an alternative treatment?
I want to take second opinion regarding the medicines prescribed to me especially in view of my medical history.
Would you suggest an alternative treatment?
Brief Answer:
There is need to cure sinus obstruction
Detailed Answer:
Hello XXXXXXX
Thanks for using healthcaremagic.
I read your query and understand your concerns.
With available history I think the first thing that need to be done is treatment of nasal obstruction and chronic sinus infection/problem. I hope you are aware that one of the common cause of chronic headache is sinus problem.
You can see an ENT doctor for detailed evaluation of sinus problem He will probably do the drainage and laboratory examination and will prescribe two weeks of antibiotics (standard practice) after taking sinus X rays or CT scan. Not to worry about your allergies as it is only plain CT scan which do not require contrast injection.
Following this it is advisable to receive anti allergic medication on regular basis like Montelukast or antihistaminic drugs.
I am not in favor of Celebrex in view of single kidney. Although it is a selective NSAIDS class of drug which has less renal damage but it is not absolutely devoid of renal side effects and we can afford even slight damage to single kidney.
Secondly I fail to understand the rational behind fluoxetine. From the available history it is not evident that you are suffering with chronic depression, anxiety or have the past history of same. In case you know the rational behind the prescription of fluoxetine let me know so it can be decided next course.
In case this was prescribed for headache and you still have the headache, it is time to change to another drug. In this situation, I will prefer tricyclic anti depressant like amitryptiline in lower dose side. I must emphasize again that this should be done after the ENT part is treated meticulously.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
There is need to cure sinus obstruction
Detailed Answer:
Hello XXXXXXX
Thanks for using healthcaremagic.
I read your query and understand your concerns.
With available history I think the first thing that need to be done is treatment of nasal obstruction and chronic sinus infection/problem. I hope you are aware that one of the common cause of chronic headache is sinus problem.
You can see an ENT doctor for detailed evaluation of sinus problem He will probably do the drainage and laboratory examination and will prescribe two weeks of antibiotics (standard practice) after taking sinus X rays or CT scan. Not to worry about your allergies as it is only plain CT scan which do not require contrast injection.
Following this it is advisable to receive anti allergic medication on regular basis like Montelukast or antihistaminic drugs.
I am not in favor of Celebrex in view of single kidney. Although it is a selective NSAIDS class of drug which has less renal damage but it is not absolutely devoid of renal side effects and we can afford even slight damage to single kidney.
Secondly I fail to understand the rational behind fluoxetine. From the available history it is not evident that you are suffering with chronic depression, anxiety or have the past history of same. In case you know the rational behind the prescription of fluoxetine let me know so it can be decided next course.
In case this was prescribed for headache and you still have the headache, it is time to change to another drug. In this situation, I will prefer tricyclic anti depressant like amitryptiline in lower dose side. I must emphasize again that this should be done after the ENT part is treated meticulously.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Doctor
Thanks for your reply.
Regarding nasal obstruction, I underwent Balloonoplasty in XXXXXXX this yeär but it did not help much neither in curing the obstruction nor headache.
The neurologist has prescribed fluoxetine perhaps because i told him that off late the pain increased due to stress. But I would like to avoid any medicine which can cause any negative impact on my kidney.
I will try to try to see an ENT again for the nasal obstruction as there exists a deviation in the central part of my nasal bone. The ENT was to rectify it along with balloonoplasty surgey but during the procedure he did not do it as he felt it was not immediately necessary.
Regards
XXXX
Thanks for your reply.
Regarding nasal obstruction, I underwent Balloonoplasty in XXXXXXX this yeär but it did not help much neither in curing the obstruction nor headache.
The neurologist has prescribed fluoxetine perhaps because i told him that off late the pain increased due to stress. But I would like to avoid any medicine which can cause any negative impact on my kidney.
I will try to try to see an ENT again for the nasal obstruction as there exists a deviation in the central part of my nasal bone. The ENT was to rectify it along with balloonoplasty surgey but during the procedure he did not do it as he felt it was not immediately necessary.
Regards
XXXX
Brief Answer:
yes going to ENT is good decision
Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.
In my view treatment of deviated nasal septum must be first priority and your plan to meet ENT is a step in proper direction.
I do not understand the use of fluoxetine for the headache. There are medicine with much better efficacy available for headache. The current guideline suggest use of low dose of Tri cyclic antidepressants for the tension type of headache. In case they are not effective or not tolerable than SSRI can be considered as a third line medication.
If you find that after your ENT correction that, there is no improvement (In my view it is not going to happen) you can ask for above mentioned drugs for treatment of headache.
Hope this clarifies the situation.
"If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health".
yes going to ENT is good decision
Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.
In my view treatment of deviated nasal septum must be first priority and your plan to meet ENT is a step in proper direction.
I do not understand the use of fluoxetine for the headache. There are medicine with much better efficacy available for headache. The current guideline suggest use of low dose of Tri cyclic antidepressants for the tension type of headache. In case they are not effective or not tolerable than SSRI can be considered as a third line medication.
If you find that after your ENT correction that, there is no improvement (In my view it is not going to happen) you can ask for above mentioned drugs for treatment of headache.
Hope this clarifies the situation.
"If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health".
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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