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Refractory Headache Gallery


>> Refractory Headache

Despite the prevalent and well-recognized comorbidity of psychiatric disorders with migraine, no studies of preventive medications specifically address patients with these comorbidities. There is little evidence to guide a clinician's decisions in treating headache patients with psychiatric comorbidity.


Management of Refractory Headache

Aggressive headache treatment belongs in the specialty clinic, with greater cost- and time-effectiveness treating intractable headaches and Migraines. Compared with the Emergency Department [ED], the outpatient headache clinic can offer a wider range of treatments and thus maximum success. We have used IV treatment in the clinic since 1994 and presented initial data regarding effectiveness in 1998. This study continues documenting degree of success of outpatient IV treatment of headaches.


Total treated patients number over 2,500, and 1,074 were treated exclusively for refractory Migraines/headaches. Approximately 1,000 patients had mixed headache and pain flareups that were treated in the clinic. We utilized, either alone or in combinations: magnesium sulfate dexamethasone (brand name Decadron) valproate sodium (brand name Depacon) droperidol (brand name Inapsine) metochlopramide (brand name Reglan) dihydroergotamine brand name DHE45 promethazine (brand name Phenergan) lidocaine propofol tramadol (brand name Ultram) levetiracetam (brand name Keppra) ketamine.

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