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Had severe chronic tension headaches. On zopiclone. In a rebound headache situation. Suggest a solution?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
Hi, I have had severe chronic tension headaches for 35 years. For many years (10-15) I have built up a decency on zopiclone tabs -up to 26 7.5 mg day and I am now in a rebound headache situation with headaches every day. I am working with doc who is trying to withdraw tabs to 13 a day for now but headaches are unbearable. Have you any advise for me?
What other info is needed
Posted Fri, 27 Sep 2013 in Headache and Migraines
Answered by Dr. Preeti Parakh 1 hour later
Brief Answer:
Try amitryptiline.

Detailed Answer:

Welcome to Healthcare Magic!

I understand that you are gradually trying to come off zopiclone and in the process, your headaches have become unbearable. You have been off alcohol for 7 weeks.

First, I agree with your doctor that such a high dose of zopiclone should not be abruptly stopped but should be gradually tapered off. However, I do not know how fast you are doing it. In my opinion, since you have been on it for so many years, you should take at least three to four weeks for reducing one tablet. Once you gain more confidence and are comfortable, you can try to fasten it up.

Secondly, for relief from the headaches, had you been under my care, I would have prescribed you amitryptiline in low dosage initially, at night. It works very well in tension headaches in low dosage and is a tricyclic antidepressant at higher dosages. If you have already tried amitryptiline and are not satisfied with it, I would suggest trying dothiepin. I would also like to assess if there are any other problems like blurred vision or dental problems etc which may be causing/worsening your headaches.

You can discuss about these medicines with your treating doctor and see how it goes.

Thirdly, apart from medicines, please also look at other options that may be available at your place, like acupuncture and acupressure. Although I have no technical knowledge of acupuncture, I have been told by some of my patients that it gives good relief from pain. So if you can find a good practitioner of acupuncture or acupressure, you may benefit from it.

Hope this helps you. Please feel free to ask if you want any other clarifications.

Best wishes.

Dr Preeti Parakh
MD Psychiatry
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