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Prescription Drugs

Medications

Several different medications are used to treat NDPH. There are no NDPH-specific drugs, so doctors often use antidepressants, anticonvulsants, or anti-inflammatories to treat NDPH. If your NDPH has migraine-type symptoms, your doctor may use triptans, ergots, or CGRP blockers. If your NDPH resembles a tension-type headache, you may try muscle relaxers like baclofen. If your NDPH involves burning or nerve pain, your doctor may try anticonvulsants or antidepressants. Other medications used for chronic pain, such as ketamine, lidocaine, or naltrexone, are also used.

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For a list of supplements commonly used to treat NDPH (including psychoactive drugs), go here.

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Medications that have been specifically endorsed as successful in treating NDPH for individuals (either through a social media group or a comment on this site's messaging system) have an asterisk (*) by them. The more asterisks, the more endorsements that particular drug has. Hopefully, as more people give feedback, I will be able to differentiate this by NDPH type to see what drugs (informally) seem to best help which type of NDPH. If you would like to comment on a medication that has been particularly helpful for your NDPH, use the suggestion box at the bottom of this page, or fill out the NDPH Survey under the "Research" tab on this site!

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***It is important to note that just because one medication in a category doesn't work for you, that does not mean that all medications in that category won't work. This is particularly true with anticonvulsant drugs. Also, in many cases it can take high doses and up to several months to truly evaluate if a drug works or not, so don't give up hope!

Abortives & Rescue Medications 

Some medications, particularly for migraine-type headaches, are used to "abort" the headache after it has already started, and are designed to be taken as needed. If your NDPH has migraine-like symptoms, you may find these medications helpful:

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Triptans/Ergots

  • Sumatriptan (Imitrex).                        

  • Rizatriptan (Maxalt)

  • Naratriptan (Amerge)

  • Zolmatriptan (Zolmig)

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Anti-Inflammatories

  • Ibuprofen (Advil)

  • Naproxen (Aleve)

  • Celecoxib (Celebrex)

  • Ketorolac

  • Eletriptan (Relpax)

  • Frovatriptan (Frova)

  • Almotriptan (Axert)

  • Treximet

  • DHE***

  • Migranal nasal spray

  • Nabumetone (Relafen)

  • Asprin

  • Indomethacin (Indocin)

  • Meloxicam

  • Diclofenac (Voltaren, Cambia)*

  • Wellbutrin (Bupropion)*

  • Zoloft (Sertraline)

  • Paroxetine (Paxil)

  • Desvenlafaxine (Pristiq)

Preventatives

Preventatives, as the name suggests, are designed to be taken long-term to prevent headache from occurring.

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Antidepressants

  • Amitriptyline**

  • Noritriptyline (Pamelor)

  • Desipramine (Norpramin)

  • Imipramine (Tofranil)

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Anticonvulsants

  • Gabapentin (Neurontin)**

  • Pregabalin (Lyrica)**

  • Levitracetam (Keppra)*

  • Oxcarbazepine (Trileptal)

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Antipsychotics & Stimulants

  • Lamotrigine (Lamictal)*

  • Lithium

  • Quetiapine (Seroquel)

  • Risperidone (Risperdal)

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Beta blockers and calcium channel blockers

  • Propranolol (Inderal)*

  • Metoprolol (Toprol)

  • Nadolol (Corgard)​

  • Dilitiazem

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MAO inhibitors

  • Isocarboxazid (Marplan)

  • Phenelizine (Nardil)

  • Tranylcypromine (Parnate)

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ACE/ACE II inhibitors

  • Candesartan (Atacand)

  • Captopril

  • Enalapril (Vasotec)

  • Losartan (Cozaar)

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Alpha-adrenergic blockers

  • Clonidine (Catapres)

  • Prazosin (Minipress)

  • Doxazosin (Cardura)

  • Doxepin (Silenor, Zonalon, Prudoxin)

  • Mirtazapine (Remeron)

  • Trazodone 

  • Fluoxetine (Prozac)

  • Escitalopram (Lexapro)

  • Citalopram (Celexa)

  • Venlafaxine (Effexor)*

  • Duloxetine (Cymbalta)*

  • Carbamazepine (Tegretol)

  • Valproate (Depakote)**

  • Zonisamide (Zonegran)

  • Diphenylhydantoin (Dilantin)

  • Olanzapine (Zyprexa)

  • Dextroamphetamine (Zenzedi)

  • Methylphenidate (Daytrana)

  • Atenolol (Tenormin)

  • Nebivolol (Bystolic)

  • Nimodipine (Nymalize)*

  • Verapamil (Verelan, Calan)*

  • Amlodipine (Norvasc)

  • Phenobarbital

  • Topiramate (Topamax, Trokendi)*

  • Lisinopril (Qbrelis, Zestril, Prinivil)

CGRP blockers

Recently, a new class of headache medications has been released that block the effect of calcitonin gene-related peptides (CGRP), which are small proteins that are highly prevalent in the sensory nerves that supply the head and the neck. These medications come as injections taken once a month or once every 3 months. New abortive CGRP blockers that can be taken at the first sign of a headache are also available. They have worked well for some NDPH patients with migraine-like symptoms.​

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  • Erenumab (Aimovig)*

  • Fremanezumab (Ajovy)*

  • Galcanezumab (Emgality)*

  • Ubrogepant (Ubrelvy)

  • Rimegepant (Nurtec ODT)

  • Eptinezumab-jjmr (Vyepti)

  • Atogepant (Qulipta)

Muscle Relaxants

Since tension-type headache is potentially caused by tight head, neck, and scalp muscles, muscle relaxants are often used to treat tension-type NDPH. These include:

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  • Baclofen (Lioresal)*

  • Tizanidine (Zanaflex)*

  • Carisoprodol (Soma)

  • Metaxalone (Skelaxin)

  • Cyclobenzaprine (Flexeril)

  • Methocarbamol (Robaxin)

Sleep Aids/Anxiety

Sleep difficulties commonly co-occur and contribute to headache. For that reason, sleep and anxiety medications are sometimes used to treat NDPH.​

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  • Alprazolam (Xanax)*

  • Lorazepam (Ativan)

  • Diazepam (Valium)

  • Chlordiazepoxide (Librium)

  • Clonazepam (Klonopin)**

  • Buspirone (Buspar)

  • Zaleplon (Sonata)

  • Zolpidem (Ambien)

  • Eszopiclone (Lunesta)

  • Ramelteon (Rozerem)

  • Zopiclone (Imovane)*

  • Cyproheptadine (Periactin)*

Anti-nausea

With migraine-type NDPH, nausea can be a bothersome symptom. The following anti-nausea medications are sometimes used for NDPH.

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  • Diphenhydramine (Benadryl)

  • Prochlorperazine (Compazine)

  • Metoclopromide (Reglan)

  • Promethazine (Phenergan) 

  • Chlorpromazine (Thorazine)

  • Hydroxyzine (Vistaril)

Opiates/narcotics

As a last resort, opioids can be used to treat pain from NDPH.​

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  • Hydrocodone (Vicodin)

  • Fentanyl

  • Tylenol #3

  • Oxycodone (Percocet)

  • Morphine*

  • Hydromorphone (Dilaudid)

  • Suboxone

  • Methadone

  • Tramadol (Ultram)

  • Codeine

Miscellaneous

A variety of other drugs can be used for chronic pain or NDPH, including:​

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  • Ketamine**

  • Lidocaine

  • Low dose naltrexone**

  • Mexiletine*

  • Memantine (Namenda)*

  • Fiorecet

  • Steroids (methylprednisolone, etc.)*

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***Disclaimer: This site is not designed to offer medical advice or replace the advice of your doctor or medical provider. It does not endorse any specific medical or non-medical treatments, approaches, or providers. Always carefully review the benefits and risks of all treatments and discuss them with your medical provider.

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