Headache. Pharmacological approach to treatment.

The great majority of headaches a physician treats in office practice can be divided into two main categories, muscular contraction headache of tension type and vascular headaches of the migraine type. The most satisfactory symptomatic therapy for tension headache is by the use of a nonnarcotic analgesic agent combined with a tranquilizer or sedative. On the other hand, symptomatic relief of migraine is best obtained by the use of a suppository of ergotamine tartrate and caffeine combined with an antiemetic or antispasmodic. Interval treatment of patients with tension and migraine headache centers on helping the patient understand his emotional problems. Prophylactic drug therapy for patients with tension headache includes the limited use of tranquilizers and sedatives. Recently, striking benefits in some patients with migraine have been achieved by the prophylactic use of the antiserotonin drug methysergide (UML 491).