Follow Up Visit 1: Part 1
Test Your Knowledge
Joe notes that Sumatriptan isn’t always helpful for his headaches. He also thinks it makes him tired. His friend takes hydrocodone for his headaches and Joe wonders if this might work for him.
True or false: Is hydrocodone an appropriate alternative medication?
Follow Up Visit 1: Part 2
Headaches evolve along a spectrum with migraine as most severe.
Follow Up Visit 2
Stress is the most commonly reported trigger of headache attacks.
Multiple Categories of Migraine Triggers
- aged cheeses (tyramine)
- alcohol (tyramine & sulfates; dehydration)
- caffeine withdrawal
- artificial sweeteners (aspartame)
- processed meats (nitrates, MSG)
- too little sleep
Bright Light, Odors
- flashing lights or screens
- birth control pills
- exercising too much
- exercising in heat
Stress Let Down
Self-care techniques are effective in reducing stress.
- Take a break
- Smile and laugh
- Get social support
Source: American Psychological Association
Mental Health Evaluation
A mental health evaluation may be needed if stress is excessive.
- Excessive stress
- Depression and anxiety
- Worsening headaches
When to Consider a Mental Health Evaluation
Consider a mental health evaluation if any of the following are experienced more days than not:
- Feeling little interest or pleasure in doing things
- Feeling down, depressed, or hopeless
- Feeling nervous, anxious, or on edge
- Not being able to stop or control worrying
Source: Kroenke et al. Psychosomatics 2009;50:613-621.