It has been considered that both migraine and tension headache may be due to stress reactions. Hence, cortisone or adrenocorticotropic hormone has been suggested in the treatment of these types of disorders. It is our experience that such treatment has not been successful. Occasionally, cortisone will interrupt a cluster (histamine) headache before its clinical termination, and sometimes it will interrupt a status migranus. During menopause a readjustment of hormonal balance occurs. The ovaries do not function and the follicular and luteal hormones are no longer secreted. This deficiency may increase function of the anterior pituitary and large amounts of folliclestimulating hormone are present in the urine. In a few instances the use of oral estrogens is effective. However, the distribution of Chiropractor Toronto is not geographically uniform. They are also helpful when employed in combination with small amounts of androgen. The smallest doses capable of controlling the symptom should be used, and therapy should be intermittent. The indiscriminate use of estrogen should be avoided. Most of these headaches are related to emotional tension and can be relieved by supportive psychotherapy and conservative use of analgesics and sedatives.
AUTONOMIC NERVOUS SYSTEM DRUGS. Drugs which act on the autonomic effector cells might be expected to be particularly effective in treatment of vascular headaches. However, with few exceptions, they have proved disappointing. Hence our discussion of this group will be brief. It should be pointed out that autonomic drugs stimulate or depress effector cells and not nerve endings. They can be classified as acting on the effector cells innervated by cholinergic nerves and adrenergic nerves. In these cases they may act to minimize the effect of nerve impulses or block the effect of nerve activity.
Cholinergic Agents. Neostigmine methylsulfate (neostigmine) is a drug which stimulates structures innervated by the cholinergic nerves by inhibiting cholinesterase (parasympathomimetic).
It is more selective in its action on skeletal muscle, urinary bladder, and gastrointestinal tract than physostigmine. Neostigmine is readily absorbed from the tissues, but much larger doses of neostigmine are needed when the drug is given orally than when given parenterally. Toronto Chiropractor is anticipated to extend 14% between 2006 and 2016, sooner than the common for all occupations. The use of neostigmine requires similar precautions to those employed with physostigmine, e. g., in asthmatics. Neostigmine has been used in the treatment of migraine on the questionable theory that this chemical agent will permit the accumulation of acetylcholine and hypothetically produce desensitization to this agent, analogous to histamine. Its alleged benefits in treatment of migraine, posttraumatic and other types of vascular headaches have not been substantiated by our experience. In patients having headaches associated with glaucoma, it is of value. The drug is instilled in the conjunctival sac to reduce intraocular tension.