reader mail You ask . We answer .
Tired of searching the Internet for answers ? It ’ s time to learn from those in the know . In every issue of Head Wise , our experts respond to reader-submitted questions about migraine and headache disorders .
Bad Medicine
In the last seven days , I have been taking the prescription medications hydroxyurea and allopurinol . This is a regimen designed to reduce a very high blood platelet count . I take one pill in the morning and the other in the evening .
Unfortunately , I have been experiencing headaches after taking each pill . I realize I am in the early days of ingesting strong medicine and can experience a wide variety of side effects . Nevertheless , there is nothing in the literature indicating that headache is a side effect of either medication . I have been prone to headaches most of my life , but these new headaches are worse than the ones I usually get . I am aspirin averse because of an ulcer . Tylenol does not give me much relief . I am 67 years old and in generally good health aside from the blood issue . I have tried migraine medications but am reasonably sure these are not migraine headaches .
I am reviewing this matter with my doctor , but any advice or information you can share would be greatly appreciated . – Marcia G . It sounds like you have a diagnosis of essential thrombocythemia , a disorder in which the platelet count is quite high . In patients with this disorder , the platelets can back up in blood vessels , which might lead to headache . In addition , rarely patients can have a stroke or blood clots in the veins of the head , known as dural venous thrombosis . If these are new-onset headaches , you might consider getting an MRI ( magnetic resonance image ) and an MRV ( magnetic resonance venograph ) of the brain if your physician thinks it is appropriate . Hydroxyurea therapy has been reported to cause headache . It is unknown how this happens , but it is possible the hydroxyurea destroys platelets containing chemicals , such as serotonin , that can trigger headaches . Typically , we would recommend aspirin or NSAIDs to treat such headaches , but if you have had an ulcer , it
8 HEAD WISE | Volume 1 , Issue 3 • 2011