Chubby walrus,

Thanks for the info on your headaches. It sounds like things exacerbate your pre-existing migraines. This is not what I was guessing so I won't prognosticate any further.

What I will throw out there is that any form of relief from headaches is welcomed. I was diagnosed with PCS and post-traumatic headache. After over 3 years, my headaches have never stopped... they are relentless. However, I have found a few things that have made life a bit easier. I still usually take an acute analgesic every day, but this seems to provide some sort of management that is very welcomed.

Here's some things I've tried:

Amitrypline (up to 50 mg), nortrypline (50 mg)... both provided very minor relief but made me feel crummy.

Cymbalta: at 30 and 60 mg it did nothing for my headache pain. However at 90 and 120 mg it provided meaningful reduction (note: still have headaches with this but they are not crippling like before). One thing, the first 2 weeks of increasing the dose made the headaches very painful, but got better thereafter.

Short term pain killers. With the Cymbalta, Advil sometimes has a noticeable effect, but often is useless. The best short-term med I've used and continue to use is Tylenol 3 (acetaminophen, 30 mg codeine and caffeine)... these are powerful and most of the time remove the pain. Generally docs don't like you using opiod pain killers daily as they cause medication overuse headache (rebound headache). Life for me would be pretty bad with these. Regular Tylenol, asperin, etc, are mostly useless

Migraine meds. These are likely your best shot for relief, though they didn't work out all that well for me. Topimerate is the go-to choice for many pain specialists dealing with headache issues. For me, it did afford notable relief but caused my heart to wildly palpitate. Propanol is often a second choice. I went to a highish dose and did get some minor relief but left me with tinnitus in one ear. There are also others that can be tried.

Lastly, I use medical cannabis in an oil form. CBD-based oils absolutely do provide some relief, which on some days is enough to not use an acute pain killer. I also use THC only oil to help me get to sleep.

My point of this is that relief of headache pain is essential to helping get through PCS. Pain leads to poor sleep, anxiety, depression, and will exacerbate other issues. Finding any relief will lessen these issues an help you progress. Even if the trial and error linked to new drugs is difficult, it might be worth it in the long-term.

Just my 2 cents. Best of luck : )

MM