Treatment of Episodic Tension-Type Headache Occurring Fewer Than 15 Days Per Month
This protocol addresses patients with episodic tension-type headache (TTH) — headache occurring on fewer than 15 days per month. Episodic TTH is classified by frequency into infrequent (fewer than 1 headache day per month) and frequent (1–14 headache days per month) subtypes.
In episodic TTH, pharmacological management centres on symptomatic (acute) treatment given at the time of each headache. Prophylactic approaches are generally reserved for patients with very frequent episodic or chronic TTH.
The recommended first-line approach uses a single acute agent from the class of simple analgesics or non-steroidal anti-inflammatory drugs (NSAIDs). Selection among the available agents within this class depends on patient-specific factors detailed in the full protocol.
References
DOI: 10.1111/j.1468-1331.2010.03070.x
Tension-type headache is classified into three subtypes according to headache frequency: infrequent episodic TTH (<1 day of headache per month), frequent episodic TTH (1–14 days of headache per month) and chronic TTH (≥15 days per month).
When it comes to pharmacological management, the general rule is that patients with episodic TTH are treated with symptomatic (acute) drugs, whilst prophylactic drugs should be considered in patients with very frequent episodic TTH and in patients with chronic TTH.
Simple analgesics and non-steroidal anti-inflammatory drugs are recommended for the treatment of episodic TTH.
Most headaches in patients with episodic TTH are mild to moderate, and the patients often can self-manage using simple analgesics (paracetamol or aspirin) or non-steroidal anti-inflammatory drugs (NSAIDs).
The guidelines for drug trials in TTH from the International Headache Society recommend pain-free after 2 h as the primary efficacy measure.
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