Management of headache in the elderly

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

The diagnosis and management of headache disorders in the elderly are challenging. The evaluation of the elderly patient with new-onset or recurrent headache requires a grasp of the heterogeneous set of causes of secondary head pain disorders. Once such aetiologies are excluded, the correct primary headache disorder must be diagnosed. Although tension-type headache is the leading cause of new-onset headache in the elderly, other primary headache disorders such as migraine can manifest in later life, and one disorder, hypnic headache, occurs almost exclusively in the elderly. Primary chronic daily headache persists in elderly patients to a greater extent than the primary episodic headache disorders do. The treatment of elderly patients with primary headache disorders is multifaceted, including acute, prophylactic and at times transitional treatments. Knowledge of drug interactions is particularly important as polypharmacy is the rule. Concomitant illnesses may require adjustments in choice or dose of drugs. In addition, as many acute and preventive treatments are either contraindicated or poorly tolerated in the elderly, modifiable risk factors for headache progression and perpetuation must be addressed. In spite of these treatment complexities, there are numerous opportunities to bring relief to older patients with primary headache disorders from the currently available therapies. New treatment options for elderly patients with headache will soon be available, including acute, prophylactic and interventional techniques.

Original languageEnglish (US)
Pages (from-to)377-398
Number of pages22
JournalDrugs and Aging
Volume27
Issue number5
DOIs
StatePublished - 2010

Fingerprint

Primary Headache Disorders
Headache
Headache Disorders
Therapeutics
Social Adjustment
Polypharmacy
Tension-Type Headache
Somatoform Disorders
Hand Strength
Migraine Disorders
Drug Interactions
Pharmaceutical Preparations

Keywords

  • Antiepileptic-drugs
  • Beta-adrenergic-receptor-antagonists
  • Caffeine
  • Calcium-channel-antagonists
  • Elderly
  • Ergot-alkaloids
  • Headache
  • Therapeutic use

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Geriatrics and Gerontology

Cite this

Management of headache in the elderly. / Robbins, Matthew S.; Lipton, Richard B.

In: Drugs and Aging, Vol. 27, No. 5, 2010, p. 377-398.

Research output: Contribution to journalArticle

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