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27 Mar 2007

please explain effects of trepeline
doctor prescribed trepeline for headaches. i would just like to get a better understanding of the drug.
Answer 507 views
Headache expert

01 Jan 0001

Dear Gesiggie,

Trepiline is a drug that is used in depression, but it has been found to be useful in some headache sufferers, particularly headaches due to muscle tension in the head and neck. It should however only be used if there has been a proper diagnosis, and if non-drug treatment has been unsuccessful. In most patients non-drug treatment is highly effective in preventing headaches, but one first has to diagnose what is causing the headache and which structures the pain is coming from. It is not a simple matter of just trying a medication without really knowing what one is treating.

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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