Condition

Tension Headache

Most common type of headache causing dull, aching pain

People Affected

Active Trials

New Cases/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Aspirin + Acetaminophen + Caffeine (Combination)

72% Effectiveness• 88% Confidence• 72% Safety• 150 trials• 18K participants

HIGH EvidenceExcellent ValueDose: 2 tablets (250mg Aspirin, 250mg Acetaminophen, 65mg Caffeine) every 4-6 hours, max 8 tablets/day

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

15-45 minutes

Duration

As needed for acute episodes (avoid overuse >2-3 days/week)

Response Rate

75%

Remission Rate

Number Needed to Treat (NNT)

Common Side Effects:

Nausea: 8%

Dyspepsia: 7%

Nervousness/Insomnia: 10%

Rebound Headache (with overuse): 15%

Annual Cost of Care

Drug Cost

$50

Monitoring

$1,000

Side Effects

$20

Total Annual

$1,070

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.05

Cost per Responder

$93.33

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+72%

Response Rate

+75%

Common Side Effects

Nausea

+8%

Dyspepsia

+7%

Nervousness/Insomnia

+10%

Clinical Trial Phases:

Phase 4

Ibuprofen

68% Effectiveness• 89% Confidence• 75% Safety• 5 trials• 75K participants

HIGH EvidenceExcellent ValueDose: 200-400 mg every 4-6 hours, max 1200 mg/day (OTC)

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

30-60 minutes

Duration

As needed for acute episodes

Response Rate

65%

Remission Rate

Number Needed to Treat (NNT)

Common Side Effects:

Dyspepsia: 15%

Nausea: 6%

Abdominal pain: 6%

Annual Cost of Care

Drug Cost

$30

Monitoring

$1,000

Side Effects

$10

Total Annual

$1,040

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.03

Cost per Responder

$61.54

Treatment Outcomes

Primary Outcomes

Headache Pain Intensity6.5 on 0-10 Numeric Rating Scale

-53.8% (-3.5 points)

Headache Impact Test (HIT-6) Score58 points (severe impact, scale 36-78)

-22.4% (-13 points)

Median Time to Onset of Significant Pain Relief120 minutes (for meaningful relief without treatment)

-62.5% (-75 minutes)

Percentage of Patients Pain-Free at 2 Hours Post-Dose10% (placebo group)

+250% (+25 percentage points)

Secondary Benefits

Ability to Perform Daily Activities4 points (significantly limited, 0=unable, 10=normal)

+75% (+3 points)

Percentage of Patients Requiring Rescue Medication40% (within 24 hours post-dose, placebo)

-50% (-20 percentage points)

Patient Satisfaction Score3 points (with previous/no treatment, 0=not satisfied, 10=very satisfied)

+133.3% (+4 points)

Common Side Effects

Dyspepsia

+15%

Nausea

+6%

Abdominal pain

+6%

Clinical Trial Phases:

Phase 4

Naproxen

65% Effectiveness• 87% Confidence• 75% Safety• 1 trials• 60K participants

HIGH EvidenceExcellent ValueDose: 220-550 mg every 8-12 hours, max 1250 mg/day (Rx), 660mg/day (OTC)

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

30-60 minutes

Duration

As needed for acute episodes

Response Rate

60%

Remission Rate

Number Needed to Treat (NNT)

Common Side Effects:

Dyspepsia: 15%

Nausea: 6%

Abdominal pain: 6%

Annual Cost of Care

Drug Cost

$35

Monitoring

$1,000

Side Effects

$10

Total Annual

$1,045

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.03

Cost per Responder

$75

Treatment Outcomes

Primary Outcomes

Headache Pain Intensity6.5 on 0-10 Numerical Rating Scale

-38.5% (-2.5 points)

Headache-Related Functional Impairment (HIT-6)56 on HIT-6 scale (range 36-78)

-8.9% (-5 points)

Need for Rescue Medication30% of patients

-50% (-15 percentage points)

Secondary Benefits

Associated Symptom Severity (Neck Pain)5.0 on 0-10 Numerical Rating Scale

-30% (-1.5 points)

Sleep Interference due to Headache4.0 on 0-10 Numerical Rating Scale

-30% (-1.2 points)

Productivity Loss due to Headache5.5 on 0-10 Numerical Rating Scale

-32.7% (-1.8 points)

Common Side Effects

Dyspepsia

+15%

Nausea

+6%

Abdominal pain

+6%

Clinical Trial Phases:

Phase 4

Acetaminophen

60% Effectiveness• 83% Confidence• 80% Safety• 2 trials• 65K participants

HIGH EvidenceExcellent ValueDose: 500-1000 mg every 4-6 hours, max 4000 mg/day

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

30-60 minutes

Duration

As needed for acute episodes

Response Rate

55%

Remission Rate

Number Needed to Treat (NNT)

Annual Cost of Care

Drug Cost

$25

Monitoring

$1,000

Side Effects

Total Annual

$1,025

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.02

Cost per Responder

$45.45

Treatment Outcomes

Primary Outcomes

Headache Pain Intensity (NRS 0-10)6/10 (moderate pain)

-33.3% (-2 points)

Pain Interference with Daily Activities (NRS 0-10)7/10 (significant interference)

-28.6% (-2 points)

Overall Headache Severity (VAS 0-100 mm)70 mm (severe)

-35.7% (-25 mm)

Secondary Benefits

Health-Related Quality of Life (EQ-5D VAS 0-100)60/100

+16.7% (+10 points)

Sleep Quality (PSQI 0-21)10/21 (poor sleep)

-20% (-2 points)

Ability to Perform Work/Study Activities (NRS 0-10)4/10 (moderately impaired)

+50% (+2 points)

Clinical Trial Phases:

Phase 4

Amitriptyline

70% Effectiveness• 88% Confidence• 60% Safety• 3 trials• 9K participants

HIGH EvidenceGood ValueDose: 10-75 mg at bedtime (titrated)

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

6-12 months, then reassess

Response Rate

60%

Remission Rate

25%

Number Needed to Treat (NNT)

Common Side Effects:

Drowsiness/Sedation: 40%

Dry mouth: 30%

Constipation: 18%

Weight gain: 15%

Dizziness: 10%

Annual Cost of Care

Drug Cost

$40

Monitoring

$300

Side Effects

$75

Total Annual

$415

Cost-Effectiveness

GOOD

QALYs Gained

0.2

Cost per Remission

$1,660

Cost per Responder

$691.67

Treatment Outcomes

Primary Outcomes

Headache Days per Month18 headache days/month

-40% (-7 headache days/month)

Headache Intensity (NRS 0-10)6.5/10 (NRS)

-23% (-1.5 points (NRS))

Analgesic Medication Use12 doses/week

-35% (-4 doses/week)

Secondary Benefits

Headache Impact Test (HIT-6) Score60/78 (HIT-6 score)

-13% (-8 points (HIT-6))

Pittsburgh Sleep Quality Index (PSQI) Score10/21 (PSQI score)

-30% (-3 points (PSQI))

Patient Health Questionnaire (PHQ-9) Score15/27 (PHQ-9 score)

-25% (-4 points (PHQ-9))

Common Side Effects

Drowsiness/Sedation

+40%

Dry mouth

+30%

Constipation

+18%

Clinical Trial Phases:

Phase 4