Tension type headaches are termed episodic if less than 15 days a month and chronic if more than 15. Almost everyone has had this type of headache. Think stress, lack of sleep, hangovers, flus. Duration is usually 1-2 hours, unlike migraine which is 4-72 hours. They are bilateral, non-throbbing, moderate in intensity, are not worse with movement such as bending over. Patients self-treat with Tylenol, ibuprofen, naproxen, etc. and do not see a physician. Chronic Tension Headaches are less common but can be disabling. Underlying stressors should be sought. Best treatment options are antidepressants in the TCA or SNRI but not the SSRI class. Examples of TCA’s are Elavil, Pamelor; SNRI’s are Effexor, Cymbalta, and SSRI’s Prozac, Lexapro. Stress management and relaxation techniques may be more effective than medications.
Tension type headaches
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