Medications

Your doctor may recommend medicine to treat or prevent tension headaches.

You might only need to take an over-the-counter medicine for pain. These medicines usually have fewer side effects than prescription drugs.

Over-the-counter drugs to stop headaches

Over-the-counter medicines that you can use to stop a headache include:

• Aspirin.
• Ibuprofen (such as Advil or Motrin).
• Naproxen (such as Aleve).
• Acetaminophen (such as Tylenol).
• Medicine that combines aspirin, acetaminophen, and caffeine (such as Excedrin).

Try to avoid taking over-the-counter drugs more than 3 times a week, because you may get rebound headaches. These are different from tension headaches. They usually occur after headache medicine has worn off. This leads you to take another dose. After a while, you get a headache whenever you stop taking the medicine.

Prescription drugs to stop headaches

In some cases your doctor may prescribe a medicine such as a barbiturate or narcotic to stop a headache if nonprescription medicines don't work. But these drugs can be habit-forming and should be used rarely and only for a short time.

Prescription drugs to prevent headaches

Your doctor may recommend that you take a prescription medicine every day to prevent headaches. You may want to take this medicine if:

• Over-the-counter medicines don't work to stop your headaches.
• You're taking drugs to stop headaches more than 3 times a week.
• You get a headache more than 15 days a month.

Medicines used to prevent tension headaches include:

• Antidepressants, such as amitriptyline.
• Seizure medicines, such as topiramate.
• Medicines that relax muscles, such as tizanidine.
• Antianxiety medicines, such as buspirone.

Headaches: Should I Take Prescription Medicine for Tension Headaches?

Botulinum toxin type A (BTX-A) is sometimes injected into the muscles in the face and head to treat headaches. In the past, doctors thought that spasms caused tension headaches. But BTX-A injections do not seem to help with symptoms of tension headaches.^{1, 2} And BTX-A may cause weakness of the facial muscles and may make it hard for you to swallow.

What to think about

• The type of tension headache you have may help your doctor decide which drug to prescribe.
• There are other things you can try besides daily medicine. For example, you could use cognitive-behavioral therapy or biofeedback.
• The medicine that you take may cause side effects. Some side effects may last for a few weeks or for as long as you take the medicine.
• You may have to try several different drugs or types of drugs before you find the one that is right for you. Make sure to tell your doctor how well a drug stops your headaches.
• Certain pain medicines can cause a bad reaction if you take them with other medicines. Before you begin taking pain medicines, be sure to let your doctor know about all of the drugs you take. This includes over-the-counter medicines and complementary treatments (such as herbs).