Headache Types and Treatment Options

What is headache?

Headache is a term used to describe aching or pain that occurs in one or more areas of the head, face, mouth, or neck. Headache involves the network of nerve fibers in the tissues, muscles, and blood vessels located in the head and at the base of the skull.

Almost everyone has occasional headaches, especially when they are sick, tired or otherwise under stress. Headache is the result of pain signals caused by interactions between the brain, blood vessels, and surrounding nerves. During a headache, the pain comes not from the brain. It comes from specific nerves surrounding the skull, head muscles, and blood vessels that are activated and send pain signals, interpreted by the brain as a headache. The reasons why these nerves are activated are not clearly understood. Most headaches go away on their own or are easily treated with over the counter (OTC) drugs.

Headache types

There are two main categories of headache: primary and secondary.

The major types of primary headaches include:

• Tension headache



• Cluster headache



• Migraine

Primary headaches are not caused by other underlying medical conditions. More than 90% of headaches are primary.

Secondary

Secondary headaches result from other medical conditions, such as cerebrovascular disease, head trauma, infection, tumor, and metabolic disorder. These account for fewer than 10% of all headaches. Head pain also can result from syndromes involving the eyes, ears, neck, teeth, or sinuses. In these cases, the underlying condition must be diagnosed and treated. Also, certain types of medication produce headache as a side effect.

Many people have occasional headaches that get better on their own or go away with OTC drug treatment. Most of these people never see a healthcare provider for their headaches, however, there are several circumstances in which an evaluation by a physician may be useful or important:

• Headaches that are getting worse over time



• Severe headaches that start suddenly



• Headaches that start after a head injury



• Headaches that always occur on the same side of the head



• Headaches that are not responding to treatment



• Severe headaches that interrupt work or the enjoyment of daily activities



• Daily headaches



• Aggravated by exertion, coughing, bending, or sexual activity

Tension Headache

Tension headaches are the most common type of headaches. They affect up to 75% of all headache sufferers. Tension headache is usually episodic but may be chronic, occurring daily or almost daily for more than 15 days a month. This type of headache is linked with tension in neck and scalp muscles, affecting blood flow within the skull.

Tension headaches often start in the afternoon or early evening. The pain is typically on both sides of the head, pressing or tightening. Some people get tension headaches in response to stressful events. Tension headaches usually do not get worse with physical activity (such as walking or climbing stairs).

Treatment

The occasional tension headache can be alleviated by a hot shower, massage, sleep, and through patient recognition and avoidance of stress factors.

For episodic tension headaches that occur less than three times per week, OTC pain relievers such as aspirin, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are convenient and effective. Combination products of pain medication with caffeine may help some people, but also may be habit forming. Use of any OTC pain reliever should be limited to no more than two or three days per week. If pain medications are overused, rebound headaches may occur on the days that medications are not taken.

Chronic tension headaches are more difficult to treat, because rebound headaches are common when pain relievers are stopped. The most effective medications for treatment of chronic tension headaches are tricyclic antidepressants (amitriptyline HCl, doxepin HCl, nortriptyline HCl). However, it is often more effective to prevent these headaches than to treat them.

Some people are able to treat their tension headaches without medications. An ice compress, a heating pad or a massage to any tight areas in the neck and shoulders can be extremely helpful. Relaxation techniques, such as deep breathing exercises or acupuncture, may help to decrease the frequency of headaches.

Cluster Headache

Cluster headaches are relatively rare, affecting about 1% of the population. They are distinct from migraine and tension headaches. Cluster headaches primarily affect men between the ages of 20 and 40. Attacks usually occur in a series, or "clusters" of 1 - 8 headaches per day over a period of several weeks to months. The pain is extremely severe but the attack is brief, lasting 15 minutes to 3 hours. The pain of cluster headache almost always occurs on one side of the head. During cluster headaches, the eye on the same side as the pain may become teary or droopy or develop a small pupil. There may also be nasal congestion on the affected side of the face.

About 80% of cluster headaches occur at night, and in about 70% of patients, drinking alcohol can trigger a cluster headache. Unlike migraine sufferers, those with cluster headache often feel better if they keep moving during the headache.

Treatment

It is difficult to stop the pain of a cluster headache that is in progress, because the headache usually disappears by the time the patient reaches the emergency room or doctor's office. Because the onset of cluster headache attacks is rapid and may occur several times a day, the best approach to treatment is with daily preventive drugs to decrease the severity and frequency of headaches. Lithium (Carbolith, Duralith, Lithane, Lithobid, Lithonate and others) and Verapamil (Isoptin, Calan, Chronovera, Verelan, Novo-Veramil) are the two drugs that are most effective at accomplishing this. Other drugs used for this purpose include Prednisone (Deltasone, Meticorten, Orasone 1, Winpred and others), cyproheptadine (Periactin) and methysergide (Sansert). Prophylactic medications usually are begun early during a cycle of cluster headaches and continued for two weeks longer than the usual cycle.

Abortive treatments include inhalation of 100% oxygen. Inhaling 100% oxygen for about 15 minutes through a facemask has proven to be helpful when it is done at the first signs of an attack. This oxygen must be prescribed by a doctor and obtained through a medical supplier. Other types of drugs that may be effective when used at the outset of cluster pain include the triptans (Imitrex, Maxalt, Zomig, Axert, Amerge), ergotamine (Cafergot) and indomethacin (Indocin).

Migraine Headache

Migraine headaches are less common than tension headaches. About 6% of all men and 18% of all women experience a migraine headache at some time. Migraine headache occurs on one or both sides of the head. The pain is typically pulsating or throbbing in nature. Nausea, with or without vomiting, as well as sensitivity to light and sound often accompany migraines. Migraines are made worse by activity, bright lights and bright noises. In most cases, migraine attacks are occasional, or sometimes as often as once or twice a week, but not daily. Women who have migraines often find that their headaches occur or worsen around the time of their menstrual periods.

One unique feature of migraines is an unusual sensation that a migraine is about to occur. This sensation is called a prodrome. Prodrome symptoms can include fatigue, hunger and nervousness. Not all people who get migraines have prodromes.

An aura is a complex of neurological symptoms that occur just before or at the onset of migraine headache. An aura involves a disturbance in vision that may consist of brightly colored or blinking lights in a pattern that moves across the field of vision. Most patients with migraine have attacks without aura. About one in five migraine sufferers experiences an aura.

Treatment

How your migraines are treated will depend on the frequency and severity of attacks. People who have a headache several times per year often respond well to nonprescription pain relievers.

There are two types of medications to treat migraines:

• abortive medications - drugs that are taken when a headache starts



• preventive medications - drugs that are taken every day to prevent migraines

Abortive Medications

Migraine-specific abortive medications usually are necessary for moderate to severe migraine headaches. When possible, an abortive medication should be taken immediately after an aura or migraine headache starts. However overusing abortive medications can lead to chronic headaches, that occur day after day without a specific cause or diagnosis. Several prescription and nonprescription drugs are used as abortive medications: aspirin, ibuprofen (Advil, Apsifen, Motrin, Nuprin and other brand names) or naproxen (Aleve, Anaprox, Naprosyn)

Effective agents available by prescription include:

• Triptans - sumatriptan (Imitrex), naratriptan (Amerge), zolmitriptan (Zomig) and rizatriptan (Maxalt). Triptan drugs are effective in 60% to 65% of patients, completely or significantly relieving migraine pain and associated symptoms within 2 hours of administration. Triptans reduce inflammation and constrict the blood vessels. The triptan with the longest history of use is sumatriptan (Imitrex).



• Ergots - sublingual ergotamine (Ergomar) and dihydroergotamine (Migranal). Ergots cause constriction of blood vessels, but ergots tend to cause more constriction of vessels in the heart and other parts of the body than the triptans, and their effects on the heart are more prolonged than the triptans. Ergots are not as safe as the triptans.



• Midrin. It is a combination of isometheptene (a blood vessel constrictor), acetaminophen (a pain reliever), and dichloralphenazone (a mild sedative)

Preventive Medications

Preventive medication are prescribed when migraine attacks that don't respond well to abortive medications or adverse reactions to abortive medications occur, migraine attacks occur too often, complicated migraines. Many drugs are listed as potentially useful to prevent recurrent migraine attacks. The drugs in the following classes are useful to prevent recurrent migraine attacks:

• Beta-blockers. Propranolol (Inderal) and nadolol (Corgard) have a good track record of being safe and effective. Metoprolol (Lopressor) and atenolol (Tenormin) are reasonable alternatives. Beta-blockers have been used for many years to prevent migraine headaches. It is not known how beta-blockers prevent migraine headaches.



• Tricyclic antidepressants. These medications are very effective, but often have troublesome side effects such as sedation, blurred vision, dry mouth and constipation. The first choice is often amitriptyline (Elavil). Nortriptyline (Pamelor, Aventyl), doxepin (Sinequan), imipramine (Tofranil) also can be tried.



• Anticonvulsants. Of the drugs in this class, valproate (Depakote, Epival) has the best evidence to support using it for prevention. Gabapentin (Neurontin) and topiramate (Topamax) also are effective. It is not known how anticonvulsants work to prevent migraine headaches.



• Serotonin antagonists. Methysergide (Sansert) has been available for many years and is very effective. Methysergide prevents migraine headaches by constricting blood vessels and reducing inflammation of the blood vessels. However, this medication has side effects that are potentially very serious and therefore is not widely used.

Rebound Headache

Increasing headache over time with repeated use of pain medicines can lead to a rebound headache. The headache is typically located on both sides of the head and is described as a pressing or tightening type of pain. When headache sufferers use too much pain medicine, their headaches often recur. This leads to a repeated cycle of taking more medicines and still having headaches. Rebound headache may appear if:

• taking analgesics on 15 or more days per month for more than 3 months



• taking opioid or combination medication 10 or more days per month for more than 3 months

When analgesics are discontinued, the headache may get worse for several days and it may take up to 30 days to recover from the rebound process. Non-drug approaches, such as biofeedback, relaxation therapy, and exercise, can be helpful in reducing both headache frequency and need for medication.

Headache Triggers

Triggers are not direct causes of the headache, but they facilitate or provoke the beginning of an attack. Anything that stimulates the pain receptors in the head and neck can cause a headache. Some of the more common triggers for headache:

• Emotional triggers: problems at work, success at work or school, anticipation, anxiety, an emotional crisis, a new job. Emotions can bring on headaches, keep them going, and make them worse. Emotions don't cause your headaches, they just make you more vulnerable to them.



• Environmental triggers: bright light, different kinds of aromas like perfume, tobacco, odors (such as gasoline), loud noises, altitude, barometric pressure changes.



• Stress triggers: strenuous exercise, excessive physical work at the work place or at school, physical sickness, not enough sleep or too much sleep



• Chemical triggers: changes in hormone levels (that occur during the premenstrual period, during the post-menstrual period), low blood sugar.



• Food and beverage triggers: caffeine, alcohol (especially red wine), hard cheese, vinegar, hot dogs, chocolate, nuts, MSG (monosodium glutamate), pizza, pork. Foods containing nitrites as preservatives can also trigger headaches. Fasting or missing meals is a major headache trigger.



• Changes in the weather can change body chemistry, and have been known to trigger headaches.



• Heavy cigarette smoking.

Yury Bayarski is the author of Price-RX.com - a prescription drug price comparison website. Please follow this link if you would like to read more about headache relief prescription drugs.

Texas Finds Hope For Treating Depression - A Genetic Link to Medication's Effectiveness

Genetic testing may help determine the most effective medications for depressed patients in the future. This month, the American Journal of Psychiatry published research citing patients' responses to the anti-depressant medication, Celexa, in association with certain genetic variations.

According to Dr. Gonzalo Laje, co-author of the study and associate clinical investigator at the National Institute of Mental Health, patients were twenty-three percent more likely to respond to the medication when a particular variation in the GRIK4 gene, along with a previously discovered variation on the HTRZA gene, were present.

"We are better able to see how genetic variations help determine how a person may or may not respond to a certain medication. This is an advancement toward personalized medicine," said Laje.

The healthcare and health insurance industries have been plagued with medical and financial issues associated with depression. In 2002, adults served by local mental health authorities in Texas included over 53,000 depression patients -- and that number only includes those who sought care at those facilities, which, by no means, reflected the whole of the depressed populace at the time.

State budget cuts to mental health services would dramatically reduce the number of those able to receive treatment, which would push problems -- many argue preventable problems -- into the emergency rooms. Ninety percent of suicides are due to untreated or under-treated mental illnesses; for Dallas, Houston, and Austin, where facilities are already overwhelmed by the sheer number of uninsured patients seeking care, any further strain could collapse a barely-balanced system.

As the population in Texas state mental hospitals goes down, the prison population goes up. According to the Texas Criminal Justice Policy Council, in 1970, there were approximately 12,400 mental health patients in state hospitals on any given day, including those suffering from depression. That number declined to just over 2,300 by 1999, while the prison mental health population rose to almost 16,000, exceeding the1970 state mental health institute population.

This dramatic increase in prison numbers has not only created problems in the general populace, but has also sucked down state funding. Texas could save an estimated $590 million a year by treating 'revolving door offenders' instead of jailing them.

While the precise number of depressed patients in each state is difficult to determine, according to the National Institute of Mental Health, there are 20.9 million adults in the United States suffering from depression at any given time. That's almost ten percent of the country.

Women are more prone than men, and symptoms are usually recognized between the ages of fifteen and thirty, though the mental health community has been taking childhood and adolescent-onset depression much more seriously in recent years. Severity ranges from mild -- which only slightly impairs functioning, perhaps manifesting itself as one "not living up to potential" -- to severe, which often devastates relationships, income, and day-to-day living, and can lead to suicide.

While depression is considered a treatable disease, just how treatable has been up for debate virtually since the illness began to be studied. Patient compliance has been a major issue, partly due to the nature of the disease itself, which produces persistent feelings of hopelessness, helplessness, worthless, and loss of interest and motivation.

The worse one feels, the harder it may be to feel hopeful and motivated enough to seek, and then follow through with, the proper care. If one does overcome these symptoms sufficiently to accept treatment, various factors, including financial barriers, accessibility problems, and lack of response to medications, can make it difficult to continue the regimen.

Lack of response to medications has been one of the more persistent and difficult obstacles to conquering the condition. For some, the first medication seems to work wonders, but many are not so lucky. Several cycles of different types of antidepressants are often required to pinpoint effective prescriptions, if they are found at all. Choice of medications are many and overwhelming, and include:




- Selective serotonin reuptake inhibitors (SSRIs), like Celexa, Paxil, Prozac and Zoloft;


- Tricycles, like Elavil, Norpramin, Tofranil, Aventyl, and Pamelor;


- Serotonin and norepinephrine reuptake inhibitors (SNRIs), like Effexor and Cymbalta;


- Norepinephrine and dopamine reuptake inhibitors (NDRIs), like Wellbutrin;


- Monoamine oxidase inhibitors (MAOIs), like Marplan, Nardil, and Parnate.





It is believed that the causes of depression are varied, and often depend on the functioning of certain neurotransmitters, such as serotonin, norepinephrine, and dopamine. Though there are commonalities among many of the medications, each can have varying side effects -- some severe - can focus on different neurotransmitters, and can produce different response levels, depending on the patient.

Laje's research could prove to dramatically shorten the lengthy trial-and-error process often necessary for determining prescriptions, as science currently has no truly effective way of profiling patients in this manner. "This [study on Celexa] gives us very relevant information to where we should be looking," said Laje, which is, at least, more progress than Western medicine has made in treating depression for quite some time.

"There's no one marker that's going to tell you whether you respond or not [to medications]. It's a lot of markers, each one having a small effect," said Dr. Julio Licinio, chairman of psychiatry and behavioral sciences at the University of Miami's Miller School of Medicine. ". . .[scientists] may be able to develop a genetic panel to tell us whether a person is likely to respond to an SSRI or not."

More and more depressed individuals are turning to natural health treatments, however, such as herbs, acupuncture, massage, and other forms of complementary medicine. St. John's Wort (Hypericum perforatum) is the most prescribed treatment for depression in Germany, and is used commonly throughout Europe for mild to moderate cases. Results of studies are mixed, however, and the National Institutes of Health is still undertaking research to determine the herb's effectiveness on mild cases. Other natural supplements used to treat depression include ephedra, gingko biloba, Echinacea, ginseng, various Chinese formulas, and SAM-e, perhaps the most promising natural treatment in recent years.

Being aware of the psychological issues affecting your health is an important part of taking care of yourself. Minding your health will certainly affect you as you age, and eventually your wallet. If you're a young individual who tries to keep informed and maintain a healthy condition and lifestyle, you should take a look at the revolutionary, comprehensive and highly-affordable individual health insurance solutions created by Precedent specifically for you. Visit our website, www.precedent.com, for more information. We offer a unique and innovative suite of individual health insurance solutions, including highly-competitive HSA-qualified plans, and an unparalleled "real time" application and acceptance experience.

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Living Migraine Free

Don't treat your migraines, prevent them. A life without migraines is obtainable, I know. I was a migraine sufferer for 12 years and have been treating... preventing them for my patients for 15 years. The 95+% success rate achieved at my office comes from a combination of research, common sense and the hard work of my patients.

When I was a teen I suffered from terrible migraines several times a week. Like most of you I tried medications and bio feedback with little help. Regular chiropractic care offered relief, but my migraines continued. Relief came to me by accident, I was doing a food shopping and did not have enough money for everything. I had choice of eating or drinking my daily 2 liter bottle of Pepsi, I chose eating. Like magic my migraines disappeared over the next week. It took several weeks to recognize that soda, alcohol, etc. were causing my migraines, but once I eliminated them I felt great. Trigger foods are well documented but aren't the whole answer.

When I first started treating patients I was sure that a simple elimination diet was the answer for my migraine patients, but many did not respond. I was determined to find the answer to treating migraines. I did a review of thousands medical research articles on migraines and found the clues I needed. The best way to treat migraines is to successfully prevent them. In order prevent migraines I needed to determine the true underlying reason migraines occur.

They key to preventing migraines is realizing that they are caused by an overload of toxins in the body. A migraine can be seen as a really severe hangover caused not by alcohol, but all types of toxins from in and out of the body. The liver, the body's main system for eliminating toxins is overwhelmed in migraine suffers. The liver is not diseased, it just is not functioning fast enough to keep the body detoxified. Simple examples of a toxin can be alcohol, chemicals, caffeine, and drugs. Toxins also include hormones and chemical compounds the body naturally produces, but cannot detoxify fast enough. Toxins can even be foods if the digestive tract cannot break them properly, such as preservatives, artificial coloring and artificial flavorings This simple concept has lead to thousands of former migraine suffers living pain free. If toxins and slow liver function lead to migraines; then reducing the toxic load and increasing the livers function will prevent migraines.

Tracey T. was 40 years old and had been suffering with migraines for 13 years. She was taking Pamelor, Topamax, Esgic Plus, and Zomig with no relief. She was under the care of a neurologist, her 4th one, and getting a migraines daily. She was in good health overall and followed a healthy lifestyle; exercised and avoided alcohol and caffeine. She began her nutritional supplements, improved her diet and increased her water intake. Her 2 month check up showed that she had had only 1 migraine in 8 weeks and several mild headaches. She was working with her doctor to eliminate her medication and was now only taking 1, at reduced amount. A six month review showed that she was off all medication and doing great.

There are 10,000s of medical studies on migraines. The medical research I reviewed overwhelmingly supports a lifestyle change with nutritional supplementation approach.

Medical Research .... How it supports this approach

1. low B vitamins and Magnesium levels ....... needed nutrients in liver detoxification

2. woman 3x more likely to suffer with migraines .... woman produce more hormones to that need to be detoxified,

3. increase frequency and severity of migraines with menstrual cycle ..........the female body produce up to 4x as many hormones during a menstrual cycle

4. elimination diets helpful .... reduces toxin intake, less to detoxify so the liver can keep up with demand

5. medications cause 30-40% of headaches ...... medications need to be detoxified by the liver, increasing the toxic load

6. triggered by smoke, perfume, etc..... smells are all chemical compounds that increase the toxic load on the liver

There are also two lab tests that support that prove that slower liver detoxification is associated with migraines. The first is a liver function test, this is not your typical blood test. A functional liver test will measure how long it takes your body to breakdown and detoxify different chemical compounds including; caffeine, aspirin, and acetaminophen. The second test in cutting edge genome scanning. Migraine sufferers have been linked to a genetic defect in liver detoxification.

The liver needs about 8 weeks of reduced toxic load and nutritional support to detoxify. When my patients start the process we ask them to keep a diary of every migraine, how severe it was and how long it lasted. Most patients start to see a decrease in the frequency or severity within 3 weeks and are migraine free by their 8th week. Woman can usually tell they are better by their 3rd menstrual cycle. You may find that the 1st and 2nd week are a little rough as you adjust to your new diet and the body dumps the toxins. The following are some guidelines to follow:

Lifestyle changes to Prevent Migraines

I recommend that my patients shoot for 100% success. The more you limit the toxins entering your body the greater your chance of success. An elimination diet alone will not work for most migraine sufferers. You will need to take nutritional supplements along with your lifestyle changes to live migraine free. Life does not always allow you to stay within the guideline, do the best you can.

Avoid the following:

caffeine and deceffeianted coffee, teas and sodas

chocolate

artificial coloring

artificial flavoring

preservatives

nuts

personal care products with heavy perfumes, switch to all natural

cleaning products, switch to all natural

cigarette smoking or second hand smoke

alcohol - all forms

Consume the following:

60-80 ounces a day

High fiber foods; fruits, vegetables, grains

Nutritional Support: to promote increase liver detoxification

Artichoke

Tumeric

Silmayrin

Glutathione

Cysteine

Cod liver oil

All natural multivitamin

B complex

Patients who are using OTC and prescription medication are slower to detoxify. Migraine suffers presently taking prescription medications should talk to their doctors. Together you can work out a plan to reduce and then eliminate your medications. Patients using medications on an as needed basis try to reduce the frequency of use, after a couple of weeks with new diet and lifestyle.

Questions and Answers:

Q: Why doesn't my doctor know this?

A: Doctors are trained to treat diseases, not dysfunction. Doctors are most likely causing 30-40% of all migraines from the migraine medication they are prescribing and the rebound effect they cause.

Q: Is your protocol safe?

A: The lifestyle changes and nutritional support recommend are very safe

Q: Can I continue on my medication?

A: Yes, continue on your medication and start the protocol when you are feeling better talk to your doctor

Q: Are there any side effects?

A: You may feel a little worse for 1-2 weeks, but it is worth it to be migraine free in about 8 weeks

Q: What kind and where can I get the nutritional supplements?

A: The nutritional supplements listed are available in any good health food store. My office use professional grade nutrients that are available only through healthcare professionals, they are not available health food stores.

I welcome your comments and questions. Please email me at szodkoy@hotmail.com if you have any questions.

Dr. Steven Zodkoy
Chiropractor
Certified Clinical Nutritionist
Certified Nutritional SpeCialist
Diplomate American Clinical Board of Nutrition

Chronic Headaches and Pain Alleviated by Dentistry

You may not immediately think of your dentist the next time you suffer from a migraine, but you might be surprised to know that there are many causes of headache, face, neck and shoulder pain that can be relieved by dental treatments. If this is not something you've tried, consider scheduling a consultation to find out if you suffer from temporomandibular joint disorder, a condition in which the upper and lower teeth are misaligned, causing muscle contractions in the jaw joint that lead to tension and pain.

A number of treatment options are available, depending on the cause of your pain. For example, you may not know it, but you might be clenching and unclenching your teeth many times throughout the day or night. This can wear down your teeth and create tension in your jaw, creating your headaches and other pain. If your dentist finds this is the case, he or she will prescribe useful home exercises and physical therapy, to be used in combination with a mouth guard that reduces the intensity and frequency of your oral stress and protects your teeth from further wear and destruction. This will restore the muscles of your head and neck area to normal length, function, posture and full range of motion, helping to reduce your symptoms.

The following treatments may also be helpful for treating chronic headaches and related pain:

Occlusal Splint - Also called a night guard, the Occlusal Splint protects the teeth from further wear and reduces the severity of grinding at night, allowing the muscles to rest. In severe cases, the splint may need to be worn all day to allow the joints and muscles to rest.

Jaw Rest - You must rest your jaw for it to heal. Do not:

- chew gum


- bite your nails


- clench your teeth together


- chew on pencils


- eat excessively chewy and crunchy foods during treatment

Moist Heat - penetrating moist heat promotes blood flow, aiding in healing and relaxation of the muscle and helping pain medications work more effectively. A wet washcloth with a hot water bottle will do, or purchase moist heating pads.

Exercises - Some simple jaw and neck exercises may be recommended to help the muscles stretch. A good time to do some of these is in the warm, moist environment of the shower or bath, particularly in the morning and/or before bedtime.

Physical Therapy - Physical therapy can help relax the muscles and increase joint flexibility. We can teach you some simple stretching therapies during your office consultation. If necessary, you will be referred to a physical therapist.

Stress Management - Stressed-out muscles that are contracted and cramped lead to pain. Emotion and stress can cause your muscles to become stressed-out. Any stress reliever that works for you is helpful. Reading, exercising, listening to music, going for a walk are all ways people reduce the stress in their lives. You may want to consider counseling to learn stress management. The point is, it is almost impossible to get relief from TMJ if your underlying emotional issues are not addressed. If you can't do it yourself, don't be afraid to ask for help.

Anterior Deprogrammer - A less well known treatment method is an anterior deprogrammer. This device contacts the four lower incisors when you close your mouth, and reduces resistance when the lower jaw moves back and forth, reducing muscle contraction intensity and helping teeth the become properly aligned. An anterior deprogrammer is meant for short term use and emergency situations.

Medication - Pain medication may be prescribed. Often, over the counter analgesics such as ibuprofen are enough. These medications relieve pain and reduce inflammation during the healing process. Occasionally a mild muscle relaxant may be prescribed.

The most effective drugs for TMJ management include:


1. Non-narcotic analgesic drugs such as acetaminophen (Tylenol).


2. Non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, Trilisate, ibuprofen, Naproxen and prescription strength NSAIDS.


3. Muscle relaxant drugs such as Carisoprodol (Soma) and Cyclobenzaprine (Flexeril).


4. Tricyclic anti-depressant medications such as Amitriptyline (Elavil), Nortriptyline (Pamelor), and Doxepin (Sinequan).

Referral - In some cases, a speCialist may be needed from physicians, oral surgeons, orthodontists, psychotherapists, physical therapists, or prosthodontists. Very severe cases may be referred from the start to a pain center or a dentist whose main focus is the treatment of temporomandibular disorders.

Dr. Michael Iott has the education, training and experience to diagnose and treat the cause of your chronic headaches and pain. Why not schedule a consultation and allow Dr. Iott to offer you the very best options to relieve your symptoms? Click here to contact Dr. Iott's office now.

What can you do to help yourself at home?

- Limit your jaw opening (yawning, etc.) to no more than 2 finger widths.


- Rest your jaw by avoiding heavy chewing (e.g. gum, bagels, tough meats).


- Avoid grinding and clenching your teeth by keeping the teeth slightly apart and the jaw relaxed.


- Avoid leaning or sleeping on the jaw.


- Avoid tongue thrusting and chewing fingernails or non-food objects.


- Avoid playing wind, brass and string instruments that stress, retrude or strain the jaw.


- Use cold/ice packs or moist heat compresses as directed by your doctor or therapist.


- Use over-the-counter medications such as aspirin, ibuprofen, Naproxen, Tylenol or Percogesic, as directed by your doctor or therapist.

If you are experiencing chronic headaches, pain in your face, neck, shoulders and upper back, or any of the other symptoms described here, call our office to schedule a private consultation.

Depression Medication

Depression can affect any one of us at any time of our lives and is more than just feeling a bit fed up or down in the dumps. When you cannot just snap out of it and the symptoms of depression persist for more than a couple of weeks, and interfere with your ability to carry out your normal routines on a daily basis, then your health care provider or GP may prescribe some form of medication to help you combat the depression.

There are many different types of anti-depressants available and the earlier ones include Tricyclic antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs). Newer types include Selective Serotonin Reuptake Inhibitors (SSRIs) and others, which may not fall into one specific category but which all work by impacting on the chemicals in the brain that are responsible for our mood and how we feel.

The following list represents the most commonly prescribed drugs for depression, their brand names and the name of the pharmaceutical company producing them (in brackets), as well as a brief description of how the different types are believed to work.

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants are so called because of their molecular structure in that they contain three rings of atoms. Although no one understands exactly how they work, it is thought that the beneficial effects are due to their ability to balance the natural neurotransmitter chemicals in the brain. The most common side effects are dry mouth and drowsiness and possibly blurred vision, sweating, and a slight hesitancy when passing urine. The following list represents some of the most commonly prescribed Tricyclic antidepressants:

- Doxepin - Brand names: Adapin (Lotus Biochemical Corporation) and Sinequan (Pfizer Inc)


- Clomipramine - Brand names: Anafranil (Geneva Pharmaceuticals)


- Nortriptylene - Brand Names: Aventyl (Eli & Lilly) and Pamelor (Novartis Pharmaceuticals)


- Imipramine - Brand Names: Tofranil (Novartis Pharmaceuticals)


- Protriptyline - Brand Names: Vivactil (Merck & Co)


- Trimipramine - Brand Names: Surmontil (Wyeth-Ayerst Pharmaceuticals)

Monoamine Oxidase Inhibitors (MAOIs)

This type of medication works by inhibiting the activity of the enzyme monoamine oxidase, which in turn increases the levels of the neurotransmitters serotonin and norepinephrine. They are not prescribed as often as they used to be as the newer type of medication known as SSRIs have become more popular. MAOIs would usually be prescribed when other medications have proved ineffective. MAOIs can interact with foods containing tyramine and raise blood pressure; they can also interact unfavourably with many other drugs and over the counter preparations. Some MAOIs include:

- Isocarboxazid - Brand Name: Marplan (Oxford Pharmaceutical Services)


- Phenelzine - Brand Name: Nardil (Pfizer Inc)


- Tranylcypromine - Brand Name: Parnate (Glaxo Smith Kline)

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs work by selectively inhibiting the reuptake of the neurotransmitter serotonin in the brain so that levels of serotonin are increased. They are generally considered safer than other types. Side effects include nausea, anxiety, sleep disturbances and sexual dysfunction. They can also interact with other drugs. Some of the more commonly prescribed SSRIs include:

- Citalopram - Brand Name: Celexa (Forest Pharmaceuticals)


- Escitalopram - Brand Name: Lexapro (Forest Pharmaceuticals)


- Fluoextine - Brand Name: Prozac (Eli & Lilly)


- FLuvoxamine - Brand Name: Luvox (Solvay Pharmaceuticals)


- Paroxetine - Brand Name: Paxil (Glaxo Smith Kline)


- Setraline - Brand Name: Zoloft (Pfizer Inc)

Some other types of medication

There are other types of medication available for depression which are not included in the previous categories but which all work in various ways to alter the balance of chemicals in the brain to alleviate depression. For example:

- Bupropion - works by inhibiting the reuptake of both norepinephrine and dopamine. Often used to treat the type of depression known as Seasonal Affective Disorder (SAD), as well as ADHD and as part of a stopping smoking programme. Brand Name: Wellbutrin (Glaxo Smith Kline)

- Duloxetine - works by inhibiting the reuptake of both serotonin and noradrenaline (SNRI). Brand Name: Cymbalta (Eli & Lilly)

- Venlafaxine - Also an SNRI. Brand Name: Effexor (Wyeth-Ayerst Pharmaceuticals)

- Maprotiline - Known as a tetracyclic antidepressant because its molecular structure consists of 4 rings in a T shape. Brand Names: Ludiomil (Novartis Pharmaceuticals)

Which type medication is most suitable?

The type of medication prescribed by your GP will depend on many factors including the kind of depression diagnosed, the severity of the symptoms, other medication that you may be taking and of course the potential risk of any side effects.

It is not possible to predict with any degree of accuracy which one will be most effective and it can take a number of weeks for any effects to be noticed. If after six weeks or so there is no improvement, then another medication may be prescribed until you find the most appropriate one for you.

Regardless of the type of depression diagnosed, the right medication can alleviate the symptoms of depression and help you get back to your old self again.

Depression is a serious condition that can strike anyone at anytime. For more information about depression and self help come and visit =>Fighting Depression.

All You Need To Know About Antidepressants

Many people often have misunderstandings about what antidepressants are capable of.

First of all, they are not pick me up pills; they don't artificially bring on a feeling of happiness, euphoria, or unrealistic well-being. Nor do antidepressants insulate you from life, make you not care about vital things, or make you oblivious to sorrow or loss.

What antidepressants do is avert depressed persons from sliding into the blackest depths of depression when something awful happens. They can still feel wounded, pain, and apprehension, but they feel these the way people normally do when they don't have depression. They also can help depressives sleep soundly, increase their energy, and improve their ability to concentrate.

The way antidepressants work is interesting. There are two chemicals, serotonin and norepinephrine, that have to do with the transmission of impulses between nerve cells in the brain and seem to be allied with depression. It would appear as if depressed people use up these chemicals at an accelerated rate than other people. Antidepressants help to retain these chemicals, apparently leading to feelings of reduced anxiety, more security, increased self-worth, assertiveness, and resilience.

There are a mixture of types of antidepressants, but they fall into a number of straightfoward categories. These are tricyclics, MAOIs, and lithium, and the newer medications: hetereocyclics and Prozac and Prozac-related drugs.

Until rather recently, tricyclics were the normal treatment for depression. These medications include imipramine (Tofranil), amitriptiline (Elacil), Vivactil, Norpramin, Pamelor, and Sinequan. Still in conventional use today, 40 to 70 percent of depressed patients improve substantially with tricyclics.

Although they are quite efficient medications, there are some negatives to their use. They generally take several weeks of constant administration to be successful, which is difficult to handle when people are sincerely distressed. Also, it is relatively easy to take a disastrous overdose. In general, tricyclics should only be used on a short-term basis. They are not addictive, but they must be used with care, especially with people who have cardiovascular disease.

Monoamine oxidase inhibitors (ie. MAOIs) include Marplan, Parnate, and Nardil. They are a different class of drugs and cause a different reaction in the brain. These drugs are helpful from some people who do not respond to tricyclics. These drugs can have disagreeable side effects, but the main disadvantage of MAOIs is that they can also cause a stroke if certain foods containing the compound tyramine (cheese, red wine, pickles) are consumed while they are being used.

Lithium is generally the treatment of choice for bipolar disorder (the cycle of manic highs with depressed lows). In the correct dose, lithium reduces by about 50 percent the chances of another manic episode within a year. Mood swings become fewer, shorter, and less harsh. The success rate for lithium treatment is 70 percent, and 20 percent of people become symptom-free. It is generally seen as a maintenance drug. Once the patient is on Lithium, they are on it for life.

One of the most well-known drugs on the market today is Prozac. It has been followed into the marketplace by many other new antidepressant medications like Zoloft and Paxil, two near cousins, Effexor and Serzone, and some more distant cousins, notably Wellbutrin, Desyrel, and Buspar.

Unlike tricyclics, which affect the levels of both serotonin and norepinephrine in the brain, Prozac, Zoloft, and Paxil affect only serotonin. Hence they are known as selective serotonin reuptake inhibitors, or SSRIs, meaning that they prevent or slow down the reabsorption of serotonin. Effexor and Serzone affect both serotonin and norepinephrine, and the others have more complex effects. All, however, have been shown to be effective in the treatment of depression. The choice of which of these medications to use for a particular person has to do with their dosage and side-effect profile. Paxil, for example, seems to have a soothing effect on anxiety that Prozac lacks. Effexor has the reputation of being more energizing than Prozac.

Compared with tricyclics, the side effects of Prozac and its cousins are usually small. Tricyclics can give you dry mouth, make you constipated, and actually slow you down, whereas Prozac has none of these problems and gives you a little more energy. However, there are some side effects with the newer antidepressants which should be mentioned. Most notable among these is a reduction of interest in sex and complications maintaining an erection. Although the male performance problems usually go away after a few weeks, many people on SSRIs report a continued diminished interest in sex, which can certainly add to marital problems.

For more info on antidepressants visit All you need to know about Antidepressants

Four Types of Depression Medication - What You Need to Know

Depression medication is not always a recommended means of treatment. There are many types of effective treatments available and they do not include depression medicines.

Depression medicines are fast acting. They provide instant result to some people but the relief is not permanent and they have side effects. Some types of depression medication are also contraindicated with some types of food. This is the reason why people who are taking depression medication need to have a diet plan that they will have to follow. Between 20 to 40 percent of people do not respond positively to depression medications.

If the person really needs the help of these pills, it is good to know the types of depression medication and have an idea of how they work and what are the associated side effects that each type can bring.

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are among the most popular types of these medications. SSRIs work on a neurotransmitter of the brain called serotonin. They are the most prescribed type of depression medication because they have fewer side effects than the older types.

The medicines classified as SSRI are the following: Paxil (paroxetine), Lexapro (escitalopram oxalate), Zoloft (sertraline), Luvox (fLuvoxamine) and Prozac (Fluoxetine). Yet another one is Celexa (citalopram). The side effects recorded for this type of depression medication include erectile dysfunction, anxiety and restlessness, hostility, agitation, dizziness, nausea, insomnia, tremors, sweating, drowsiness, fatigue, either diarrhea or constipation, headaches, dry mouth and either weight gain or loss.

SSRI can increase the suicidal tendency of a person. If a person has taken SSRI and wants to switch to MAOI, he should allow three weeks difference before taking MAOI; if not, it could lead to reactions that have grave consequences for the person's life.

Tricyclic Antidepressants (TCAs)

Tricyclics antidepressants are older than SSRIs. Taking this medication requires two weeks before relief could be felt and they have more side effects than SSRIs. Tricyclic antidepressants works on two of the three neurotransmitters of the brain called the serotonin and norepinephrine. But it was also observed that they are interacting unnecessarily with the other nerve impulses of the brain. It has a sedative effect on the user, making it suitable for patients that are severely depressed.

The list of TCA medicine include Adapin (doxepin),Sinequan (doxepin), Anafranil (clomipramine), Pamelor (nortryptyline), Surmontil (trimipramine), Tofranil (imipramine), Vivactil (protriptyline), Elavil (amitriptyline), Norpramin (desipramine). Also included are Pertofrane (desipramine), Endep (amitriptyline) and Ludiomil (maprotiline).

The side effects of SSRI can also be observed with TCAs. In addition, people taking it are very sensitive to the sun, and may have blurred vision and difficulty urinating.

Monoamine Oxidase Inhibitors (MOAIs)

MAOIs are the oldest type of antidepressant. They are taken by people with mild cases of depression and those that are overly sensitive with the environment. MAOIs work on all three neurotransmitters: the serotonin, dopamine and norepinephrine. MOAIs are recommended only when the patient has not responded to the other types of medications.

A person taking MAOIs must be watchful of his diet. Many types of food are known to counter-react with MAOIs. The list includes chocolates, wines, and cheeses, among others. Effects of these food with MAOIs include hypertension, headaches, fluctuation in blood sugar among diabetics and at worst, brain hemorrhage could happen.

The medicines classified under MAOI are the following: Nardil (phenelzine), Parnate (tranylcypromine), Marplan (Isocarboxazid) and Emsam (Selegiline ). The side effects include lightheadedness upon standing, sleepiness, headache, insomnia, impotence, dizziness and weight gain.

Atypical or Other Types of Antidepressant

These are the latest modes of anti depression medication and they do not fall under any of the first three types, thus they are classified as atypical. Since these medications have different mechanism of actions, the side effects also vary according to the specific medicine.

The list of atypical types of depression medication includes the following: Trazodone (Desyrel), Venlafaxine (Effexor), Nefazodone (Serzone), Duloxetine (Cymbalta), Mirtazapine (Remeron) and Bupropion (Wellbutrin).

Never forget to ask for medical assistance before starting on any of the types of depression medication. It is also useful to know that many of them can increase the tendency of suicide attempts in a person. Abrupt withdrawal must also be avoided. All types of depression medication need tapering down in order to lessen the side effects that could be very serious.

Flor Serquina is a successful Webmaster and publisher of Facts-About-Depression.com. She provides more information on topics such as types of depression medication, new treatments for depression and depression chat rooms that you can research on her website even while lounging in your living room.

Fibromyalgia, Tools for Survival

Fibromyalgia is a chronic condition categorized as a form of arthritis. Fibromyalgia is characterized by widespread pain in the muscles, ligaments, and tendons. Common symptoms of fibromyalgia include fatigue, headaches, painful menstrual periods, tingling or numbness in the hands and feet, morning stiffness, multiple tender points on the body, and sleep difficulty. Common sites of pain include the back, shoulders, neck, pelvic girdle, and hands but any body part may be affected.

The cause of fibromyalgia is not known. However, many factors can contribute to fibromyalgia. Researchers believe that disturbances in sleep patterns may be a cause of fibromyalgia rather than a symptom. Viral or bacterial infections may also be a trigger. Injury or trauma that affects the central nervous system may be a cause of fibromyalgia. An imbalance in neurotransmitters in the brain may also be a cause of fibromyalgia. Serotonin is one such neurotransmitter that researchers believe is linked to cause fibromyalgia along with depression, migraines, and gastrointestinal distress. Abnormalities in the autonomic nervous system may be a cause of fibromyalgia. Fibromyalgia may also be caused by changes in muscle metabolism such as deconditioning and decreased blood flow.

Fibromyalgia affects people in early and middle adulthood but can affect children as well. Those affected by rheumatoid arthritis, lupus, or ankylosing spondylitis are more likely to develop fibromyalgia. A family history of fibromyalgia also increases the chance of developing this disorder. Those with sleep disorders such as restless legs syndrome or sleep apnea have an increased risk of developing fibromyalgia.

Fibromyalgia is not a progressive or life threatening disease. The symptoms of fibromyalgia vary in intensity. There are many treatments that can improve the symptoms of fibromyalgia.

Certain medications can treat the pain involved with fibromyalgia. Certain analgesics used to treat fibromyalgia include: acetaminophen, NSAID's (non-steroidal anti-inflammatory drugs), and Ultram (Tramadol). These medications may be used in conjunction with each other for better pain relief. However, Ultram must be prescribed by a physician while NSAID's (ibuprofen, naproxen, aspirin) and acetaminophen (Tylenol) are available over the counter.

Antidepressants may be prescribed by your doctor to treat fibromyalgia. Such antidepressant medications that may be prescribed include: Pamelor, Elavil, Doxepin, Prozac, Paxil, and Zoloft. These medications may be prescribed in conjunction with each other. These medications treat serotonin levels in the brain and may also promote sleep.

Those affected with muscle pain and spasms may need to take a muscle relaxant such as Flexeril at bedtime. Your doctor may also prescribe a benzodiazepine to promote sleep and help relax muscles. Certain sleep medications such as Ambien are classified as a benzodiazepine. However, these medications are not recommended for long term use because of the increased risk of dependence.

Your doctor may help you to create a unique treatment program involving cognitive-behavioral therapy and an interdisciplinary program. Cognitive-behavioral therapy involves teaching patients to deal with stressful situations. Interdisciplinary treatment programs may involve relaxation techniques, biofeedback, and education regarding chronic pain.

Self care is also very important in treating fibromyalgia. Self care includes reducing stress, achieving adequate sleep, exercising regularly, and eating a healthy diet. There are also alternative therapies that might help alleviate the stress and pain associated with fibromyalgia. These therapies include chiropractic care, massage therapy, meditation, yoga, acupressure, physical therapy, light aerobics, aromatherapy, herbs, nutritional supplements, myofascial release therapy, application of heat/cold, and acupuncture.

Visiting a doctor of osteopathy may be beneficial for treating fibromyalgia. Doctors of osteopathy are licensed to perform the same therapies and procedures as medical doctors but are also taught the use of manipulation to address joint and spinal problems. A doctor of osteopathy may be more apt to see the subtle signs of fibromyalgia.

There is no cure for fibromyalgia yet, but hope is on the horizon. The fibromyalgia patient has many resources to help deal with this disorder such as support groups, organizations, and medical professionals to help improve your quality of life. Fibromyalgia is not life threatening and treatments tend to improve the severity of the symptoms over time. There are many tools that the fibromyalgia sufferer can use to become a fibromyalgia survivor!

Copyright 2006 Kristy Haugen

Kristy is a mother and experienced nurse. She has a Bachelor in Biology and Chemistry and writes to inform individuals interested in health information.

Relief For Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. RA is a systemic disease, often affecting extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles. Rheumatoid arthritis can also cause inflammation of the tissue around the joints, as well as other organs in the body.

Rheumatoid arthritis is two to three times more common in women than in men and generally strikes between the ages of 20 and 50. But rheumatoid arthritis can also affect young children and adults older than age 50. About 60% of RA patients are unable to work 10 years after the onset of their disease. Rheumatoid arthritis is a common rheumatic disease, affecting more than two million people in the United States. The disease is three times more common in women as in men. It afflicts people of all races equally.

RA can affect any joint, but the most common places are the hands or feet. Rheumatoid arthritis (RA) causes redness, pain, swelling or a hot (or warm) feeling in the lining of a joint, the place where 2 or more bones come together. Worldwide, about 1% of people are believed to have rheumatoid arthritis, but the rate varies among different groups of people.

Rheumatoid arthritis is different from osteoarthritis, the common arthritis that often comes with older age. Rheumatoid arthritis is rarely associated with pyoderma gangrenosum, a necrotizing, ulcerative, noninfectious neutrophilic dermatosis. RA can affect body parts besides joints, such as your eyes, mouth and lungs. RA is an autoimmune disease, which means the arthritis results from your immune system attacking your body's own tissues.

Rheumatoid arthritis most often affects the smaller joints, such as those of the hands and/or feet, wrists, elbows, knees, and/or ankles. RA may start gradually or with a sudden, severe attack with flu-like symptoms. It's important to remember that RA symptoms vary from person to person. In some people the disease will be mild with periods of activity or joint inflammation and inactivity. Along with painful, inflamed joints, RA can cause inflammation in other body tissues and organs. In 20% of cases, lumps called rheumatoid nodules develop under the skin, often over bony areas.

Treatments for arthritis have improved in recent years. Corticosteroids. These medications, such as Prednisone and methylprednisolone (Medrol), reduce inflammation and pain, and slow joint damage. Medications used to control RA fall into two categories: those that relieve symptoms and those that have the potential to modify the course of the disease. Exercise is also an important part of a treatment program. Immunosuppressants medications act to tame your immune system, which is out of control in rheumatoid arthritis.

Some of the commonly used immunosuppressants include leflunomide (Arava), azathioprine (Imuran), cyclosporine (Neoral, Sandimmune) and cyclophosphamide (Cytoxan). These medications can have potentially serious side effects such as increased susceptibility to infection. Rituximab-Rituximab reduces the number of B cells in your body. B cells are involved in inflammation. The most common antidepressants used for arthritis pain and nonrestorative sleep are amitriptyline, nortriptyline (Aventyl, Pamelor) and trazodone (Desyrel).

Rheumatoid Arthritis Treatment Tips

1. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin and others), naproxen (Naprosyn, Aleve), Celecoxib (Celebrex) and many others.

2. Light exercise may be beneficial for improving blood circulation to joints.

3. Various anti-cytokine medications are now being used to treat painful disease states such as Rheumatoid Arthritis.

4. Nonsteroidal anti-inflammatory drugs (NSAIDs) is a type of medicine that reduces pain and swelling.

5. Severely affected joints may require joint replacement surgery, such as knee replacement.

6. Corticosteroids are man-made drugs that closely resemble cortisone, a hormone natural produced by the body.

7. Immunosuppressants medications act to tame your immune system, which is out of control in rheumatoid arthritis.

Juliet Cohen writes articles for health and fitness and diseases treatment. For more information visit our site at http://www.healthfitnesstips.org/.

Post Traumatic Headaches - Life After the Car Accident

Many times after a car accident people will have initial neck pain, are seen in the emergency room and treated. If the injuries are not life threatening they are sent home with some medication and told to rest. Unfortunately, many will start to have headaches, even if they have never had headaches before. Those with a history of headaches will find their headaches are getting worse. Most of the time the headache will dissipate over a week or two and everything will be fine.

But what if the headaches don't go away? What happens and what do people do if the headache gets worse? Post traumatic headaches that get better in four to six weeks are considered acute headaches, but those that stay at the same pain level, start to get worse, or go beyond six weeks are more concerning. The headaches may be all over the head and moderate in pain with breakthrough stabbing, throbbing pain on one side. This more severe form of headache is associated with migraine symptoms and indeed is a migraine.

At this point most people will reach for the over the counter medications such as Excedrin or Tylenol. Failing that, they may try the medication the doctor in the emergency room gave them and most of the time these treatments are quite successful. However, there is a certain percentage of people who will not respond to this treatment and as a result will start taking more and more medication. The headaches will begin to get worse for two reasons.

First of all, the medication will start enhancing the headaches and cause a condition known as analgesic rebound headache syndrome. In this case, the headache pain goes up and the person grabs the Excedrin which brings the headache down a bit. But, as the medication wears off, the headache starts getting bad again. More medication, more bouncing up and down in pain levels. Eventually, the medication stops working but the person still keeps taking it in desperation because they don't know what else to do. They might got to their doctor and get stronger drugs, such as Lortab but this only makes the situation worse.

Secondly, the medication used at this point is all wrong. Post traumatic headaches respond best to low doses of tri-cyclic anti-depressants such as Elavil or Pamelor. Elavil is generally accepted as being the best medication, but most doctors make the mistake of using migraine doses (10-50mg). Unfortunately, post-traumatic headaches do not respond to this dose but most people do respond when the dose is slowly titrated up to 75-150 mg. Fortunately, this medication is also excellent for any associated neck pain and spasms!

The breakthrough migraines are treated just like that..like migraines. A small dose of an anti-seizure drug may also be necessary with triptans (Imitrex or Maxalt) for when the pain is bad.

Don't forget, like all other headache syndromes, lifestyle is very important. Regular sleep cycles, good diet and exercise as tolerated will all help the headaches get better. In this particular case, however, the vitamins and herbs used to successfully treat migraines do not have much of an effect on post traumatic headaches. None the less, many people do want to try them to help the migraine component.

The key to post traumatic headache syndrome is to find a headache speCialist and be patient. If the headaches are severe, chances are that it will take several months for any one treatment to have an effect. Most people are not aware of this fact in headache treatment, so they tend to start and stop treatments after a few days or weeks and become discouraged. The longer the brain has the treatments on board, the greater the chance it will heal.

Mary K. Betz, MS RPA-C is a practicing Physician Assistant in neurology who specializes in headache medicine. For more information visit http://www.headache-adviser.com

Depression Treatment

Lots of people endure from depression, and it's not something that anyone need be embarrassed of. This is an important starting point for those who are in need of treatment. Depression should be treated like any other bodily illness, and like other physical illnesses it can often be fixed with prescription drugs. Having said that, it can also frequently be dealt with without drugs, through psychotherapy.

Psychotherapy unfortunately also has a stigma associated to it in the minds of various people, but it is nothing more than a form of counselling where the depressed person is given an occasion to chat about life and the way they feel. The very process of being able to talk about pain and misery in a non-judgemental environment can have an immensely healing effect, especially for those who are suffering mild or moderate cases of depression. Severely depressed persons do not generally profit from psychotherapy and counselling to the same extent. Severe depression generally requires supplementing counselling with other depression treatments. Even so, counselling is not only a good starting point in the process, but a competent counsellor will generally be the best person to give advice as to the need for more treatment.

Severe depression needs medication and sometimes hospitalisation. Even then, it can often take some time to get treatment right, as there are a selection of antidepressant drugs available on the market and some of them can have dangerous side-effects.

Part of the reason for the popularity of antidepressants such as Prozac or Zoloft is that they usually have a small number of side-effects, apart from a regular diminish of libido, and hence are relatively safe to prescribe. However such drugs do not work at all for some people who may require 'tricyclics' such as Vivactil, Norpramin or Pamelor. The problem with tricyclics is that it can cause problems for those already suffering with heart disease, and getting the correct dosage right is far more tricky than with Prozac or Zoloft. People certainly have been known to seriously overdose on tricyclics.

These issues highlight the need for antidepressant medication to be administered by a trained psychiatrist and not by a general practitioner. A good psychiatrist will also be the best person to dictate if the individual should be hospilatised.

For those who need to be hospitalized, electric shock therapy (ECT) is another form of treatment that has proven very valuable to some people. This is generally only used with people who have rare and harsh symptoms of depression and who have become manic. ECT is usually only considered for those who have not been successful on antidepresasnt medication and when all other types of treatment have failed to make the symptoms of the depression less acute.

ECT involves electrical stimulation that causes the brain to seizure in order to lessen the depression. While this sounds shocking, this treatment should not be associated with the torturous forms of shock therapy frequently seen in films. Today, patients who are given ECT you are also given muscle relaxants so as to remove all discomfort and pain. ECT is generally used in conjunction with both antidepressant medication and counselling. Sometimes the ECT will let a person to become free of a depressive episode after which they will be able to look after their equilibrium through the use of normal antidepressants.

Dealing efficiently with depression can obviously be very testing, and the cost (financially as well as physically) can be high, but these costs generally pale in comparison to the toll taken by depression that is left untreated.

For more information on treatments for depression visit Depression Treatment

Pros and Cons of Taking Medication for Manic Depression

Medication is not usually used as a first line of defense against manic depression. Often, the patient has to undergo psychotherapy before the doctor will finally decide if he or she needs to take antidepressants. The reason for this is that the effects of these medications can differ from patient to patient. And these effects can either be beneficial or, sometimes, fatal to patients.

Of course, the medications for manic depression are designed to cure the patient suffering from it. However, since it is a mental illness, it cannot be avoided that other patients would react negatively to the drug while others find the drug relatively helpful.

Manic depression occurs when there is an imbalance with the neurotransmitters. Neurotransmitters are chemicals that control the functions of the brain. When there is an imbalance among these neurotransmitters, either mania or depression occurs.

From here, let us discuss the pros and cons of manic depression medications:

At present, there are 4 groups of antidepressants:

1) SSRIs or Selective serotonin reuptake inhibitors


2) MAOIs or Monoamine oxidase inhibitors


3) TCAs or Tricyclic


4) Lithium carbonates

SSRIs are antidepressants that fix the serotonin levels of the brain. Popular SSRIs are sertraline (Zoloft), fLuvoxamine (Luvox), Fluoxetine (Prozac) citalopram (Celexa), paroxetine (Paxil), and escitalopram oxalate (Lexapro).

There are new SSRIs, the nefazodone (Serzone) and the venlafaxine (Effexor) that work not only to fix the serotonin levels of the brain but also another neurotransmitter, particularly the norepinephrine. Another antidepressant, the bupropion (Wellbutrin), affects dopamine and norepinephrine, more than the serotonin.

MAOIs or Monoamine oxidase inhibitors (phenelzine and tranylcypromine) inhibit the MOI (an enzyme works to break down certain neurotransmitters) at the same time reinstate the normal mood of the patient.

TCAs or Tricyclic antidepressants relieve depression by maintaining the right amount of neurotransmitters in the central nervous system. Popular tricyclic antidepressants are despiramine (Norpramin), imipramine (Janimine and Trofanil), amitriptyline (Elavil), and nortryptyline (Pamelor)

Lithobid and Eskalith are Lithium carbonates that reduce the excessive activity of the brain.

Other antimanic medications include carbamazepine (Tegretol), divalproex sodium (Depakote), and lithium citrate (Cibalith-S).

All these, of course, are created for the benefit of the patient suffering from manic depression, especially the episodes of depression. However, since they are drugs, the effects may not be as desirable as they have to be; because, there are several patients that experience several side effects in taking these drugs.

Side effects could range from hair loss, motor problems, weight gain, headaches, tremor, diarrhea, anxiety, reduced sexual performance or drive, nausea, to dry mouth depending on what type of medication is given.

The occurrences of these side effects still depend on each patient. Some can claim that they experience at least one of the mentioned side effects while others can experience two or more. It should be noted that these are unavoidable but if the patient thinks that the medication he or she is taking gives more harm than good, the choice to continue now depends on him or her with the advice of his or her doctor.

As a precautionary measure, the patient should consult an expert psychiatrist or a qualified doctor with experience of handling cases of manic depression. Alternatively, ask for other types of treatment that may work more effectively like alternative medicines, psychotherapy, or for the worst cases of manic depression - electroconvulsive therapy.

The author of this article, Matthew OConnor runs a site dedicated to the latest news and developments in depression treatments, particularly the crucial topic of medication for manic depression.

How Antidepressant Drugs Work

While not necessarily addictive, antidepressant drugs can cause serious side effects that lead to erratic behavior. Such side effects create a dangerous situation in the workplace, the home, while driving and in many other instances. Those antidepressant drugs of particular concern are tricyclic antidepressants.

Amitriptyline is an antidepressant drug that goes by the brand name Limbitrol. Nortriptyline is also a part of the tricyclic antidepressant family and is prescribed as Aventyl and Pamelor. Doxepin is used to treat both depression and anxiety and can be found under the names Adapin and Sinequan. Desipramine is sometimes also prescribed to treat eating disorders and withdrawal symptoms from cocaine addiction. It is sold under the name brands Norpramin and Pertofrane.

How Do Tricyclic Antidepressants Work?

Antidepressants work by helping to maintain certain levels of neurotransmitters, chemicals called serotonin and norepinephrine in the brain. These chemicals help to regulate mood and modes of thinking. By elevating a person suffering from depression's mood, antidepressants alleviate the feelings of hopelessness, sadness and the general lack of interest in living associated with their condition. The medication is typically taken as an antidepressant pill, but is also available in syrup form.

Effects of Antidepressant Drugs

Antidepressant drugs, especially tricyclic antidepressant drugs can cause a whole array of side effects. Side effects include, upset stomach, dry mouth, increase in skin sensitivity, insomnia, drowsiness, changes in sex drive, changes in appetite and confusion. Serious antidepressant side effects that require medical attention include constipation, difficulty in speaking, irregular heartbeat, trembling, stiffness of limbs and hallucinations. Tricyclic antidepressants also create an increased likelihood of thoughts of suicide and attempts in children and adolescents. Any sudden behavior changes, mood swings or extreme agitation should be relayed to your child's doctor.

Signs of Tricyclic Antidepressant Overdoses

Someone overdosing on tricyclic antidepressants exhibits many signs and should be taken to a medical facility immediately. Warning signs of a potential overdose include seizures, dilated pupils, pounding or irregular heartbeat, hallucinations, difficulty breathing, severe drowsiness, and vomiting.

How To Test For Antidepressant Drugs

While antidepressant drugs are a prescription medication with legitimate uses, they can be potentially dangerous to those who work in fields that require the operation of heavy machinery and other hazardous activities. There are many different kinds of drug testing kits that test for tricyclic antidepressants in one's system, such as urine drug tests, saliva drug tests and hair follicle drug tests.

Having an employee that is under the influence of antidepressant drugs such as amitriptyline, nortriptyline or doxepin can be potentially dangerous, not only to themselves, but to other employees and the health of your company. That is why performing drug tests at your workplace to detect antidepressant use can keep your workers safe, your reputation sound and your company producing to the best of its ability.

As a parent, the prescription drugs your child or teenager is taking is obviously of concern to you. But the potential side effects of some drugs like tricyclic antidepressants are astounding and should be carefully monitored. To test your teen for amitriptyline use, nortriptyline use, doxepin use, desirpramine use and other antidepressant drugs that have been shown to increase the likelihood of suicidal thoughts in adolescents, a drug test kit can help to calm your mind and decide what is best for your child.

A longer version of this article is located at Anti-Depressant.org. The article is prepared by Serhat Pala who runs the website TestCountry.com.

Some of the information used in this article are taken from:Common misspellings for Tricyclic Anti-Depressants

Depression - Finding The Right Medication

Once it has been established that a person is suffering from clinical depression, help for the condition is fairly easy to get. Even "regular" physicians are so informed about depression that they can prescribe treatment for it. It's no longer necessary (in most cases) to see a speCialist to get a diagnosis or medication for it.

If the patient chooses treatment in the form of medication, there are many options available. Each medication has some side effects, so it's just a question of trying different medications until the right one has been established. With most of the medications, results can be seen within three to six weeks, given that the patient takes them on a regular basis and that the dosage is adequate for the patient.

Treatment in the form of medication is usually divided into the following categories:

- SSRIs (Selective serotonin reuptake inhibitors) are medications such as Zoloft, Luvox, Paxil and Prozac. These are the most prescribed drugs for the treatment of depression They only have a few and tolerable side effects, such as mild headaches, insomnia, feeling very sedated, nausea and a decrease in interest in sex. The later can be helped with a small dosage of special medication and the other side effects usually wear of within a few days. They are safe in overdose.

- SNRIs (Serotonin-norepinephrine reuptake inhibitors) such as Effexor and Serzone also have good results. The side effects are about the same as the SSRIs, except for the sexual side effects. They are also safe in overdose.

- Bupropion (Wellbutrin) has restlessness, anxiety and insomnia as side effects. It is not safe in overdose, since higher amounts of this medication can cause seizures. It is therefore also not recommended in treatment of depressive patients with epilepsy. - Mirtazapine (Remeron) is fairly new on the market. The known side effects are weight gain and a sense of sedation. Due to the later, it is only used at night. It is safe in overdose.

- TCAs (Tricyclic Antidepressants) such as Elavil, Pamelor and Norpramin are one of the first types of medication used in treatment of depression. It has quite a lot of side effects and has to be monitored closely by the physician. Despite of this, it is an effective treatment and many patients turn to it when all other treatment forms have failed. The most common side effects are blurred vision, dizziness or feeling lightheaded that can lead to a fall, constipation, urinary problems, dry mouth, a feeling of sedation, heart palpitations and weight gain. It can be fatal in an overdose.

- MAOIs (monoamine oxidase inhibitors) such as Parnate and Nardil are also older forms of medication that are especially used in the treatment of atypical depression, where the patient complains of unexplained body aches, excessive sleeping and overeating. When all else fails, this form of medication is often prescribed. It does come with a lot of side effects though, the same as TCAs. During usage of this medication the patient has to follow a very strict diet. He must avoid all food high in the amino acid tyramine, which are contained in liver, aged wines and cheeses, broad beans and other foods. The patient also must avoid taking any sort of cold medications that contain pseudoephedrine. Mixing the medication with the mentioned foods or a decongestant can be fatal.

No matter which medication form the patient and doctor decide to go with, results are even better if the medication is taken while the patient undergoes psychotherapy.

Michael Russell

Your Independent guide to Depression

Phentermine Precautions - Steps For Safe Phentermine Weight Loss

Even though it is well known that side effects caused by the Phentermine drug are of temporary nature but certain precautions are to be followed strictly to avoid further complications. It is observed that some of the patients are facing sever complications and that may due to various reasons such as not carrying out regular exercises, improper diet plans, not referring to the doctor or not following the correct prescription, taking Phentermine drug during late night or missing out the regular doses and taking double doses of Phentermine drug. Another important reason is not purchasing the Phentermine drug from the authorized dealer.

Secondly patients suffering from prolonged diseases should not opt for the Phentermine drug and in case of emergency they should immediately contact their family doctor for further advise. In case if a obesity patient is suffering from various side effects of the Phentermine such as nervousness, loose motion, constipitation, irritability and high blood pressure patients should immediately refer to their physician. It is better to inform complete medical history to the doctor so that he can take proper decision while prescribing the weight loss drug. Especially patients suffering from diabetics, active thyroid problems, glaucoma and hypertension should not opt for the Phentermine drug. Even the pregnant ladies and breast-feeding mothers are advised to stay away from this weight loss medicine. Even normal cough and cold medicines may harm the obesity patient in case of Phentermine drug.

Whenever you purchase Phentermine drug from medical store please check the suitability of the drug from the doctor. Also inform him if you are already taking other weight loss medicine. At the same time check for the label on the bottle for the expiry date and for other information details so that you can be aware of the various ingredients of the Phentermine drug. Restrict or avoid the use of various inhibitors such as phenelzine and selegiline if you taking Phentermine tablets.

Next important precaution to be taken while following the Phentermine drug is that, do not consume decongestants and caffeine products as it increases the heartbeat rate and may lead you in danger. Same times avoid smoking and taking alcohol that may increase your problems. Carry out regular exercises and follow the proper diet plans. These provide quick results and reduces chances of various side effects.

In case you are undergoing any surgery or other medical treatment provide all the information about the Phentermine drug to your doctor. Remember that appetite suppressants are not meant for planned diet thus proper diet plans are to be considered along with proper exercises. Prescribed doses are to be strictly followed and proper timings are to be adhered while taking the Phentermine drug. Do not worry if you have missed a particular dose. Avoid going for long drives and carrying out heavy jobs.

Do not opt for the antidepressant drugs such as Amoxapine Asendin, Imipramine Tofranil, Amitriptyline Elavil, Nortriptyline Pamelor and Desipramine Norpramin once you are taking the Phentermine drugs as it slow downs the effects of the weight loss drug.

If all the above-mentioned precautions are properly followed by the obesity patient while taking the Phentermine drug you will succeeding in your plan to reduce the extra weight.

These precautions are to be used as guide lines only and are not to be taken as authority. For further information readers are advised to talk to their doctor.

Learn more about Phentermine and how this diet pill may help you win the weight loss battle. Why not educate yourself and possibly change your life for the better? One of the top websites about Phentermine is Phenforum.com, an online weight loss community offering diet tips, support groups, free articles and education on weight loss, phentermine info, and a list of pharmacies that are safe and reliable to order from. Heck, even if you don't take advantage of all the help they offer, at least educate yourself on weight loss by subscribing to their free newsletter. I've received many tips to help me get through tough times with my weight loss! Just visit their site, http://www.phenforum.com and fill out the form at the top where it says, "Start losing weight!"