Occipital Neuralgia And Anti-Depressants/Anti-Convulsion Medication
Occipital neuralgia is a relatively uncommon condition. For this reason it is not the condition that immediately springs to mind when a patient present s with persistent and chronic headaches that can be quite disabling. All too frequently the patient is suspected of having a migraine and medication to treat migraines is prescribed, but unfortunately they do not (and indeed cannot) treat occipital neuralgia (being designed to treat migraines) and thus they are ineffective.
Another round of tests and discussions may take place and often the diagnosis is made that the ‘problem’ could be cluster headaches, but again, this is not getting to the root of the problem; the root cause of the pain is occipital neuralgia and it is this which requires treatment.
So, after some time, the correct diagnosis may be made, but patients are often confused and slightly cared by the medication they may be prescribed. After all, they may have suffered with the neuralgia for some time and been quite distressed by the condition. Then they are hopeful that they will receive the ‘correct’ treatment, but are suddenly prescribed anti-depressants, even though, apart from the depression caused by pain they do not feel depressed and they may never have had a seizure: so what is going on?
Choice OF Medication
The medication chosen such as anti-depressants or drugs that may help stop seizures are only being prescribed because of the way that they can also stop pain being felt within the body. They are not being prescribed because the patient is either depressed or potentially will have seizures, it is their pain control role that is being used here, nothing to do with their primary function. In a sense their pain control is a ‘by product’ and it is the by product which is being used.
Difficulties With Medication
The problem with the long term use of anti-depressants or medication that may help prevent seizures is that these are generally very potent medications. Because they are potent, they can often come with side effects that can range from mildly irritating to quite unpleasant. They are also not a preferable treatment for the longer term.
Alternative To Medication For Occipital Neuralgia
Although medication is only prescribed when it can is viewed as necessary, not all patients are comfortable with taking such medication due to the side effects and concerns that it dulls all the senses, although the pain is alleviated.
If this is the case, it may be worth considering a nerve block to the occipital nerve. This is not an invasive technique, but one where local anaesthetic and cortisone (a steroid) is injected into the neck muscle in the region where the occipital nerve passes through the muscles. This eases pain because the anaesthetic immediately dulls the pain and thereby the patient feels better and then the cortisone kicks in, at a very slow rate, but this also acts as a way to soothe the nerves and inflammation and after a week there is often a very significant reduction in pain; up to 80% of patients feel better.
So if you do have occipital neuralgia and do not want to take medication, a nerve block may be the answer to your problems!