You are currently viewing Chronic Daily Headache Management : Mnemonics

The mnemonic “DIAGNOSE” can really help you know the essence of the management of Chronic Daily Headache which can be easily confused with normal headache.

I made this mnemonic during my med school, but still now it helps me to remember about the pertinent points of management of this important headache.

Chronic Daily Headache (CDH) is a type of headache defined by headaches occurring on a daily or near-daily basis for an extended length of time, often lasting more than 15 days per month for at least three months. CDH can be disabling and have a substantial influence on the quality of life of persons who have it.

Chronic Daily Headache Management Mnemonic  :

    • D: Diagnose any secondary headache and treat that problem 
    • I: Identify the underlying cause that triggers worsening of a primary headache
    • A: Amitriptyline or nortriptyline at doses up to 1 mg/kg are very useful for CDH arising from migraine or tension-type headache, or where the secondary cause has activated the underlying primary headache
    • G: Give tricyclics in low doses (10-25 mg daily) and 12 h before the expected time of awakening to avoid excessive morning sleepiness
    • N: Newer medications like topiramate, valproate, propranolol, flunarizine, candesartan, and CGRP pathway monoclonal antibodies or gepants-CGRP receptor antagonists are also useful when the underlying issue is migraine
    • O: Overall, diagnosis of the headache type will guide therapy
    • S: Secondary headache should be ruled out before treating primary headache
    • E: Expect a challenge when secondary cause triggers worsening of primary headache

Mnemonic: DIAGNOSE


Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department