Q. My daughter, who is 15 years old, had viral meningitis in August, and although the meningitis is gone, she continues to have daily headaches. The doctors continue to contribute these headaches to the meningitis and say it will take time. The pediatric neurologist just wants to continue medicating her, which is not really helping her. The doctor does not want her to take Advil or Tylenol due to the chance of rebound headaches. She is on Elavil, 37.5mg daily, and Fiorinal for pain. The narcotics make her sleep 12 hours but do nothing for pain. I do not know what else to do for her. We went to the emergency room two weeks ago with severe pain. The ER doctors put her on an IV of Toradol, Reglan and Benadryl, which after several hours did alleviate the pain. Is there any research regarding post-meningitis headaches and treatments, and is there anything else that can be causing these headaches, or is it truly a migraine?

Amitriptyline is included in a group of medications classified as tricyclic antidepressants. Amitriptyline is one of the first successful medications in this class to be developed. It was discovered in the late 1930s before scientists had today’s understanding of the chemistry of the brain. This drug was developed as a way to reduce anxiety. Frequently, people with depression are often very anxious. When amitriptyline was given to patients with anxiety, it also improved the depression. This result prompted further research and the development of newer agents to treat depression. As scientific understanding of the brain progressed, scientists discovered that amitriptyline and related compounds worked on a series of chemicals called neurotransmitters. The antidepressants influenced the production and efficiency of these neurotransmitters.

Prozac (fluoxetine) is an antidepressant affecting serotonin. It is unlike the older tricyclic types such as Elavil® (amitriptyline). It has not been shown to be effective in reducing migraine frequency. It is the earliest compound approved in the group known as serotonin reuptake inhibitors. Several...