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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for chronic headaches

Answered by
Dr.
Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3650 Questions

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Posted on Mon, 17 Apr 2017 in Brain and Spine
Question: I wonder how depacote prescribed for cronic headaches can affect a 87 year old man suffering from chronic headaches, no diagnosis is clear. once has one seizure due to alcohol . but had no seizure since, seizure meds are being prescribed. how can depacote help. he is still pretty good with his mind some mild forgetfullness. all this meds are effecting his abilities to function age appropriate.
doctor
Answered by Dr. Olsi Taka 1 hour later
Brief Answer:
Used for headache prevention, but has its risks particularly at that age

Detailed Answer:
I read your question carefully and I understand your concern.

Depacote is commonly used for prevention of migraine, it is a first choice therapy so if he has been diagnosed for migraine it is a good choice. It can help with other types of chronic headache though less proven.
As for possible side effect there can be many such as drowsiness, dizziness, fluid retention, vision issues, coordination issues etc. In an elderly man the risk is naturally higher.
Looking at his other medication I see that you mention two other anti seizure medication like Kepra and Gabapentin (though there must be some error with keppra as there is no 10 mg dosage, perhaps you meant 1000 mg). Given together there is the added risk of side effects, especially dizziness and drowsiness. For that reason I would recommend discussing with your doctors the possibility of withdrawing (gradually) one of those two, perhaps Kepra, as depakote may cover for its action anyway.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 39 minutes later
Thank you your response was good, What would you suggest we edo to have an accurate or close to accurate diagnosis. It seems that his symptoms are being treated. and the symptoms are not going away,

. what else can we do? H e also has macular degeneration. would the hedaches be caused by eye problems?
please let me know what you know. thanks
doctor
Answered by Dr. Olsi Taka 21 minutes later
Brief Answer:
More information is needed.

Detailed Answer:
Macular degeneration in itself doesn't cause headache, I do not think that is the cause.

As for what to do it might be useful if you provided some more details, such as when did headaches start and their evolution in time, location, duration of episodes, frequency, character (throbbing, pressure like, lancinating etc), triggering factors (stress, lack of sleep, alcohol etc), other accompanying symptoms (such as nausea, vomiting, lacrimation, nasal congestion, visual changes etc), medications tried for headache etc, conditions like neck arthritis, high blood pressure etc.

Judging from the present information I would start by reconsidering present medication. Medication acting on nervous system can at times cause headache. For that reason the need for anti seizure medication should be carefully evaluated. You mention him to have had only one seizure. Only one seizure is generally not considered enough of a motive to start treatment, in particular when it was due to a removable cause such as alcohol. Only when there are at least two seizures is treatment recommended. Medication like Kepra may in 15-20% of patients actually cause headache. So if certain it was only one seizure I would talk to your doctor about possibility of gradually withdrawing medication. They can't help his mental performance esp at that age, at times that alone is a trigger for tension type headache.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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