[The present treatment of headaches (author's transl)]

Considered from the point of view of clinical practice, the treatment of chronic headache may be either symptomatic and etiological or physiopathological. Progress in symptomatic treatment depends first on the reasonable and graduated use of pure analgesics, looking out for the toxic side effects of the usual drugs and then the fairly definite efficacy of certain psychotropic drugs. The discovery of an etiology gives a specific dimension to the treatment: either anti-cerebral oedema drugs with above all tetracosactide, a diagnostic test of cerebral tumours, or antidepressor or tranquillizer drugs, depending on the variety of disturbance to be corrected. An attack of migraine always benefits from ergotamine used occasionally and in limited dosage (not more than 6 mg daily or 10 mg per week). For the basic treatment the drugs act mainly peripherally and fairly regularly in the following order: methysergide, beta-blockaders, pizotifene, cyproheptadine, oxetorone. Other drugs have a central effect, Tiapridal, MAO inhibitors which are too often neglected, and clonazepam which is not very easy to use.