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HeadWay, Issue #058 -- Whiplash headache
May 21, 2008

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In this month's issue:

Whiplash headache

Serotonin Syndrome

Say what?!  Selective Serotonin Re-uptake Inhibitors (SSRIs)

Whiplash headache

I received an email recently from a fan of . . . but, I'm sad to say, it was a disappointed fan. Gary from the USA is dealing with cervicogenic headache from whiplash, and was disappointed that he couldn't find even a mention of whiplash on the site! Shocking? Yes indeed.

Well, in my defense there are a huge mountain of topics to cover. But I was convinced enough that I put up an article the same day I read Gary's email - so we now at least have an introduction to the topic!

So tell me about whiplash headaches...

If you're living in a world where people with whiplash walk around with neck collars, you probably need an update. Let's take a quick look at whiplash and related headaches, and then you can go to the site for more.

Whiplash headache is not a medical term for a specific type of headache. It's more of a layman's term for a type of headache from neck trauma.

Whiplash happens when your head is jerked back and forth. Commonly this is from an auto accident, but it could also be from a punch, or a sports injury. What exactly happens is unclear, but we know some damage to the neck's muscles and ligaments is involved.

Headache isn't the only symptom, of course. There's also neck and upper body pain, dizziness, vision and memory problems, to name a few.

Usually within about 3 months the symptoms are gone - but sometimes symptoms like headache may last a year or more. Catching the problem early increases your chances of success.

How are whiplash headaches treated?

Neck collars aren't always recommended like they were in the past. Keeping the neck from moving can cause more problems. Instead, doctors often prescribe careful stretching and strengthening exercises for the neck, and may even suggest physical therapy if the problem goes on for a long time. Exercise is so important that your doctor may even prescribe injections to allow you to do gentle exercise without having major pain and muscle spasms.

Ice and heat therapy are commonly recommended. Massage and chiropractic treatment are a help to a lot of people. Sometimes medication may be used for the pain - most often over the counter pain relievers.

One thing I've learnt about headache from whiplash injury is that, although it can be frustrating and painful, it is treated with a great deal of success, even if it has been an issue for many months. So if you're struggling with continued pain from whiplash, there is hope!

Read more in the new article, Headache Whiplash Injuries. Thanks, Gary!

Serotonin Syndrome

Last week in the news were new concerns about something called serotonin syndrome. This is something to note for anyone taking a triptan drug to stop migraine.

Serotonin sydrome, also called serotonin toxicity or serotonin toxidrome, Hyperserotonemia and serotonergic syndrome, is a life threatening drug reaction, where the body ends up with too much serotonin (a neurotransmitter).

Serotonin syndrome is actually fairly rare, do don't throw all your triptan drugs out yet. The biggest concern in the past has been with people who take more than one drug that can lead to increased serotonin in the body.

Examples of triptans would be Maxalt (rizatriptan), Imitrex (sumatriptan), Zomig (zolmitriptan) and Treximet. Other drugs that may contribute include many anti-depressants, such as Prozac (fluoxetine), Paxil (paroxetine), and Nardil (phenelzine), to name a few. Some herbs such as St John's Wort may also contribute. You shouldn't be taking two types of these drugs together without careful supervision of a doctor who knows your medical history.

That wasn't really the news. The news, in the 15th of May issue of the New England Journal of Medicine, was that cases are showing up in people who are only taking triptans. And they weren't overdosing either.

The average age of patients with serotonin sydrome who were taking triptans was 40.

Why am I writing about this? First, when you see the headlines, you need to remember this is still very rare. Second, we all need to be reminded about the dangers of drugs interacting together in unexpected ways. Third, you need to let your doctor know if you're experiencing strange symptoms, such as...
  • tremor
  • stiffness
  • agitation, restlessness and hyperactivity
  • mental confusion
  • palpitations
For more about this recent finding, read this article: Migraine Medications May Cause 'Serotonin Syndrome' from the Washington Post, and this description of serotonin sydrome.

Say what?!  Selective Serotonin Re-uptake Inhibitors (SSRIs)

One of the types of anti-depressant mentioned above is the Selective Serotonin Re-uptake Inhibitor, or SSRI.  One of the best known drugs of this class is Prozac.

We don't know exactly why SSRIs help alleviate depression.  But SSRIs get their name because they keep certain cells from re-absorbing the neurotransmitter, serotonin.  That way, more serotonin is available to the brain, improves the sending of messages in the brain, and so improves mood.

Feedback? Ideas for future issues? Visit the HeadWay MailRoom. Your password is nomoache.
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