Treatment

Most people who assume they have sinusitis actually have migraines or tension-type headaches.

Migraines and chronic or recurrent headaches may be treated with prescription medication that is either taken every day to reduce or prevent headaches or taken at the onset of a headache to prevent it from getting worse.

To treat these types of headaches, your doctor may recommend:

• Over-the-counter pain relievers. Migraines and other types of headaches may be treated with over-the-counter medications, such as acetaminophen (Tylenol, others), naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB).

• Triptans. Many people with migraine attacks use triptans to relieve pain. Triptans work by promoting constriction of blood vessels and blocking pain pathways in the brain.

  Medications include sumatriptan (Imitrex, Tosymra, others), rizatriptan (Maxalt), almotriptan, naratriptan (Amerge), zolmitriptan (Zomig), frovatriptan (Frova) and eletriptan (Relpax). Triptans are available as tablets, nasal sprays and injections.

  A single-tablet combination of sumatriptan and naproxen sodium (Treximet) has proved to be more effective in relieving migraine symptoms than either medication on its own.

• Ergots. Ergotamine and caffeine combination drugs (Migergot, Cafergot) are less effective than triptans. Ergots seem most effective in those whose pain lasts for more than 72 hours.

  Ergotamine may cause worsened nausea and vomiting related to your migraines and other side effects, and it may also lead to medication-overuse headaches.

  Dihydroergotamine (D.H.E. 45, Migranal) is an ergot derivative that is more effective and has fewer side effects than ergotamine. It's available as a nasal spray and in injection form. This medication may cause fewer side effects than ergotamine and is less likely to lead to medication-overuse headaches.

• Anti-nausea medications. Because migraines are often accompanied by nausea, with or without vomiting, medication for nausea is appropriate and is usually combined with other medications. Frequently prescribed medications are chlorpromazine, metoclopramide (Reglan) or prochlorperazine (Compazine).
• Glucocorticoids (dexamethasone). A glucocorticoid may be used in conjunction with other medications to improve pain relief. Because of the risk of steroid toxicity, glucocorticoids shouldn't be used frequently.