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What medications can help prevent tension headaches?

The tricyclic antidepressants amitriptyline (Elavil, Endep) and doxepin (Adapin, Sinequan) have proven most effective for preventing tension headaches. One study found that three out of four people taking daily amitriptyline reported significant improvement in their head pain. Because they cause drowsiness, tricyclic antidepressants are particularly useful for those who have both tension headache and insomnia. If one tricyclic isn't effective, another may work. Changing the dosage can also help.

A long-acting muscle relaxant, such as cyclobenzaprine (Flexeril) or tizanidine (Zanaflex), can also stave off tension headache. Like their fast-acting relatives, these drugs slow the central nervous system, indirectly relaxing tense muscles. They also have similar side effects, including drowsiness and fatigue. Unlike carisoprodol or metaxalone, these drugs take an hour or so to work; however, their effects can last as long as a day. To reduce the likelihood that side effects will disrupt your routine, you should take cyclobenzaprine or tizanidine only once daily, before bedtime.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.