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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 8999
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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Doctor, male, 31 years old. I suffer from chronic tension

Customer Question

Hello, Doctor,
I am Georges Hosri, male, 31 years old.
I suffer from chronic tension headache for 2 years . I consulted several neurologues and made ​​two treatments with Botox but without effective result.
My last treatment was as follows:
* 8 drops Rivotril (Clonazépam) + 5mg Sibelium + 50mg Anafranil (Clomipramine).
When I increase the dose of Anafranil to 75 mg the headache increases.
How can you suggest to me? Thank you
Submitted: 8 months ago.
Category: Neurology
Customer: replied 8 months ago.
The other medications in 2years: Venlafaxine (150mg) + Inderal + Tryptisol.
Expert:  Dr. Frank replied 8 months ago.

You are probably getting headaches because of the anti-cholinergic effects of Anafranil. It is vitally important that you hydrate yourself well with fluids if you are taking this medication. If you are getting a dry mouth taking this medication, that is the side effect which is making your headache worse, if you can prevent the dry mouth, you will help your migraine. Migraine is a vascular reactive type of headache, so just overloading the plasma volume by staying well hydrated helps, Anafranil will try to reduce the vasodilation associated with the acute tension episode, by effecting serotonin receptors on the endothelial membrane of the blood vessel as well as in the brain itself. Have you ever tried triptan type medications as for migraine (sumatriptan, eletriptan?) or ergot alkaloids (cafergot?). Get back to me to discuss this further if I can help, and I will reply. Or if satisfied, please remember to rate this service by clicking on the rating stars as that is how I am compensated for this work. I can also call you by Skype if you wish, I will put out the phone option. If interested, please place your number in the box, and a time to call if not now. thanks *****

Expert:  Dr. Frank replied 8 months ago.

I hope I was able to answer your question. If satisfied, please remember to rate my service by clicking on the rating stars, as that is how I am compensated for my work. thanks dr Frank