Hello dear, Thanks for being on healthcaremagic.com.If your brother would have presented to me as an outpatient,I would have made the following clinical explanation- If your brother is having episodic throbbing headache it can well be migraine.Some of the other typical symptoms are- 1)nausea 2)Photophobia and phonophobia(headache worsens on exposure to bright light and sound) 3)Visual aura If these symptoms are present in your brother,it is likely migraine .But,it is hard to understand that why he is behaving dangerously and refusing to take medicines.It is not a feature of migraine headache. He is taking agomelatine which is an antidepressant,that suggests that he is having some kind of psychiatric component. Please visit a physician and a psychiatrist.He probably needs an integrated management from both specialities..Hope it helps.