How we can help patients with chronic daily headache?


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Treatment of patients with chronic daily headache (CDH) is one of the most difficult problems in neurological practice. The combination of drug and non-drug therapies - the basis of the modern approach to the treatment of CDH. In our country, pharmacotherapy of headaches often involves the appointment of neurometabolic and vasodilator drugs, and non-drug therapy includes massage, physiotherapy and manual therapy. In world practice, these methods do not have evidence of efficiency and are not recommended for the treatment of CDH. The article deals with modern and effective methods of treatment of patients with CDH. The results of own authors’ observation of 62 patients (6 men and 56 women) with CDH aged from 23 to 78 years (mean age, 47.19±11.79 years) are presented, the analysis of the inefficiency of prior treatment is performed. Clinical case has demonstrated the effective treatment of patient suffering from CDH using behavioral therapy and antidepressant duloxetine. The data on the efficacy of duloxetine in CDH are discussed. It is emphasized that duloksetin is an effective and well tolerated drug for the treatment of patients with CDH and comorbid illnesses such as anxiety and depressive disorders, chronic nonspecific lower back pain, and fibromyalgia.

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