[Therapeutic concepts in the treatment of headache]

One of the most common forms of primary headache is tension headache with a dull pressure-like pain on both sides of the head. In addition to treatment with acetylsalicylic acid, paracetamol or ibuprofen, the application of cold and relaxation techniques have proven to be of use. Chronic forms are treated with tricyclic antidepressants such as amitriptyline. Unilateral cluster headache responds to inhalation of oxygen and subcutaneous and intranasal treatment with tryptan. By way of prophylaxis, prednisone, verapamil, lithium carbonate and topiramate are applied. For persistent drug-induced headache, withdrawal is the first-line treatment. The more rare forms of nonsymptomatic headache include paroxysmal hemicrania and trigeminal neuralgia, in the prevention of which carbamazepine, phenytoin or oxcarbazepine have proven of value.