Gabapentin in the prophylaxis of chronic daily headache: A randomized, placebo-controlled study
R. A.Nash, 5589 Greenwich Road, Suite 175, Virginia Beach, VA 23462-6564bob@doctornash.com
Submitted May 05, 2004
I read with interest the article by Spira and Beran and the
Silberstein’s Highlight and Commentary about chronic daily headache. [1,2] I
wish to share my clinical perspective of chronic daily headache (CDHA) and
my treatment protocol, which gives very successful results. I think that
many headaches referred to as rebound headache or transformed migraine,
are actually variants of fibromyalgia, consisting of recurrent muscle
spasms and non-restorative sleep. Most CDHA are really a pain in the
neck associated with an alpha-delta sleep disturbance. At
delta sleep, the muscles relax maximally, the brain produces maximum
amounts of endorphins and the autonomic nervous system (ANS) resets. CDHA
patients have not slept deeply for months or years. A 13 question intake
form assists me in ordering the correct antidepressant. [3] The form may be
accessed online. [4] The following may interfere with the maximum
production of the endorphins at delta sleep: alcohol, barbiturates,
benzodiazepines and narcotics. Restoring alpha delta sleep patterns with
the appropriate antidepressant, the avoidance of the four substances known
to inhibit production of endorphins, with head and neck exercises and
acupuncture , if needed, gives both the patient and the practitioner
satisfaction.
References
1. Spira PJ, Beran RG. Gabapentin in the prophylaxis of chronic daily
headache. Neurology; 61: 1753-1759.
2. Silberstein, SD. December 23 Highlight and Commentary: Gabpentin in the
treatment of chronic daily headache. Neurology 2003; 61: 1637.
3. Nash, RA. The Serotonin Connection. J of Orthomolecular Medicine
1996;11:35-44.
4. Doctornash.com [click on "Headache", then "How I treat chronic
headache"]
I read with interest the article by Spira and Beran and the Silberstein’s Highlight and Commentary about chronic daily headache. [1,2] I wish to share my clinical perspective of chronic daily headache (CDHA) and my treatment protocol, which gives very successful results. I think that many headaches referred to as rebound headache or transformed migraine, are actually variants of fibromyalgia, consisting of recurrent muscle spasms and non-restorative sleep. Most CDHA are really a pain in the neck associated with an alpha-delta sleep disturbance. At delta sleep, the muscles relax maximally, the brain produces maximum amounts of endorphins and the autonomic nervous system (ANS) resets. CDHA patients have not slept deeply for months or years. A 13 question intake form assists me in ordering the correct antidepressant. [3] The form may be accessed online. [4] The following may interfere with the maximum production of the endorphins at delta sleep: alcohol, barbiturates, benzodiazepines and narcotics. Restoring alpha delta sleep patterns with the appropriate antidepressant, the avoidance of the four substances known to inhibit production of endorphins, with head and neck exercises and acupuncture , if needed, gives both the patient and the practitioner satisfaction.
References
1. Spira PJ, Beran RG. Gabapentin in the prophylaxis of chronic daily headache. Neurology; 61: 1753-1759.
2. Silberstein, SD. December 23 Highlight and Commentary: Gabpentin in the treatment of chronic daily headache. Neurology 2003; 61: 1637.
3. Nash, RA. The Serotonin Connection. J of Orthomolecular Medicine 1996;11:35-44.
4. Doctornash.com [click on "Headache", then "How I treat chronic headache"]