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Table 12

From: Reference programme: diagnosis and treatment of headache disorders and facial pain. Danish Headache Society, 3rd edition, 2020

Pharmacological treatment of tension-type headache
• Treatment of the individual episode (NSAID, paracetamol).
• Avoid overuse of analgesics.
• Avoid opioids.
• Prophylactic treatment should be considered for chronic tension-type headache when there is insufficient effect of non-pharmacological treatment.
• Amitriptyline, mirtazapine and venlafaxine may have preventive effects.
• Remember to inform that antidepressants are given to increase the concentration of pain-inhibitory neurotransmitters in the central nervous system and not to treat depression.
• Use a headache calendar to monitor the treatment effect
• Prophylactic medication should be discontinued after 6–12 months to see if there is still a need for the medication.