Drugs & Aging

, Volume 27, Issue 5, pp 377–398 | Cite as

Management of Headache in the Elderly

  • Matthew S. RobbinsEmail author
  • Richard B. Lipton
Review Article


The diagnosis and management of headache disorders in the elderly are challenging. The evaluation of the elderly patient with new-onset or recurrent headache requires a grasp of the heterogeneous set of causes of secondary head pain disorders. Once such aetiologies are excluded, the correct primary headache disorder must be diagnosed. Although tension-type headache is the leading cause of new-onset headache in the elderly, other primary headache disorders such as migraine can manifest in later life, and one disorder, hypnic headache, occurs almost exclusively in the elderly. Primary chronic daily headache persists in elderly patients to a greater extent than the primary episodic headache disorders do. The treatment of elderly patients with primary headache disorders is multifaceted, including acute, prophylactic and at times transitional treatments. Knowledge of drug interactions is particularly important as polypharmacy is the rule. Concomitant illnesses may require adjustments in choice or dose of drugs. In addition, as many acute and preventive treatments are either contra-indicated or poorly tolerated in the elderly, modifiable risk factors for headache progression and perpetuation must be addressed. In spite of these treatment complexities, there are numerous opportunities to bring relief to older patients with primary headache disorders from the currently available therapies. New treatment options for elderly patients with headache will soon be available, including acute, prophylactic and interventional techniques.


Migraine Melatonin Topiramate Cluster Headache Memantine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this review. Dr Robbins has no conflicts of interest that are directly relevant to the content of this review. Dr Lipton has received personal compensation for activities with Advanced Bionics, Allergan, AstraZeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Cierra, Endo, GlaxoSmithKline, Minster Research, Ltd, Merck, Neuralieve, Novartis, Kowa, Pfizer and Ortho-McNeil as a consultant. He holds stock or stock options in Minster and Neuralieve. He has received research support from Allergan, Ortho-McNeil, Minster, Endo, GlaxoSmithKline, Merck, Neuralieve and ProEthics.


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Copyright information

© Adis Data Information BV 2010

Authors and Affiliations

  1. 1.The Montefiore Headache Center, Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxUSA
  2. 2.Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxUSA

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