One reason headache medications may fail to work is that the majority were originally developed for treating other diseases. While medical science has focused its efforts on finding a cure for killer diseases like cancer and heart disease, research into the causes and cure of headaches has been ignored. Primarily, this is because headaches are not usually life-threatening.
In 1987, the National Institutes of Health spent only $932,000 on headache research compared to over $500 million on heart disease. The result is that few drugs have been developed primarily for headache relief; and as far as curing chronic headaches goes, the other drugs don’t appear to be getting the job done.
Headache drugs are classified as either abortive painkilling drugs or as prophylactic drugs.
Abortive Painkilling Drugs. Chief among these are the nonsteroidal anti-inflammatory drugs (NSAIDs) which inhibit synthesis of prostaglandins, hormone-like substances essential to the headache process. The principal NSAIDs include aspirin, acetaminophen and ibuprofen, all available OTC. These drugs work best on tension headaches.
Besides causing irritation or bleeding in stomach and intestines, continued use of aspirin may erode the intestinal lining and cause an ulcer, ft can also impair blood coagulation, increase the tendency to bleed, lead to a higher risk of iron-deficiency anemia in younger women, and increase risk of a bleeding-type stroke. Nor are acetaminophen or ibuprofen panaceas. Each has a discouraging list of adverse side effects.
Once migraine begins, it can be stopped only by a powerful vasoconstrictor tike ergotanune, a drug so fraught with side effects that it is prescribed only for severe migraine or cluster headache. Even then, it can be used only periodically. The steroid prednisone, occasionally prescribed to halt a cluster headache bout, has such a list of severe adverse side effects that it is used only when all else has failed.
Painkilling cocktails that often include codeine, tranquilizers or barbiturates are also commonly prescribed. All are addictive, and they are much overused. The analgesic lidocaine, another heart disease drug prescribed to relieve cluster headache, also carries a long list of adverse side effects.
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