Therapy without medicaments
Improving physical fitness with jogging, hot and cold showers, brushing massages, eventually sauna. Regular lifestyle, no excessive drinking, no smoking, no lack of sleep or oversleeping.
Non analytic psychotherapy, relaxing techniques e.g. yoga, autogenic training (Schultz), biofeedback. Physical competition sport to get rid of aggressions. Loss of overweight by controlled fasting. Acupuncture, neural therapy, physiotherapy to improve body posture.
Therapy with medicaments
Prophylactic therapy with Dehydroergotamine, eventually combined with a peripheral sympathicomimetic vasoconstrictor. If there is no low blood pressure and no extreme vegetative bradycardia a betablocker with no intrinsic sympathicomimetic activity or also Flunarizine can be tried. In acute headache Aspirin or Paracetamol should do.
In major depression adequate antidepressant medication should be given. In agitated or psychotic patients the respective neuroleptics should be tried. Flunarizine can lead to impairment of the condition.
Low dose antidepressant medication, e.g. with Amitryptiline eventually together with low dose betablockers like Propranolol or Metoprolol. In acute and non bearable tension headache Dispirin or Paracetamol and a muscle relaxant like Diazepam can be given. Don't choose combination drugs (e.g. Aminophenazon plus Caffeine plus Barbiturate plus Codeine), they may lead to addiction and toxic respectively drug-induced headache.