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05 Sep 2007

Bi Polar 1 Cluster headaches
Dear Dr
I am a Bi Polar 1 sufferer with chronic cluster and tension headaches. I am on Effexor 150mg am and 75mg nocte and take Serequel 200mg nocte as well as Urbanol 10mg nocte. I usually wake up with a headache and it progresses from a cluster headache in the morning to a bad tension headache late afternoon. I sleep 8 hours a night and also have sternoclydomastoid muscular pain from an overbite and grinding my teath at night. I see a Chiropractor monthly and go for massages regularly. My Chiropractor says that I have fibrositis on over the shoulder area and we can't seem to get rid of it. I use Adco-Dol four times a day and I know that it may be rebound headaches that I am getting. Please advise as to best treatment options.
Answer 608 views
Headache expert
headache expert

01 Jan 0001

Dear Collette,

I agree - using that many Adco-dol certainly leads to rebound headaches. Although one feels that one just has to take something for the pain, “rescue” medication is not the correct approach. The correct way to deal with the problem is to have a proper diagnosis of the causes of the headache. If the causes are treated, the headaches no longer occur, and it is no longer necessary to rely on potentially harmful “rescue” medication.

To get to the root of the problem, you need what is called a “multidisciplinary assessment”. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.
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