Table 12

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.