How can you tell if it’s somatic or NDPH or other headache disorder
Head Pressure History
Approximately one year ago, I developed constant daily head pressure. The onset was sudden and clearly remembered. The symptoms began shortly after my olanzapine dose was reduced from 7.5 mg to 5 mg while my fluoxetine (Prozac) dose was increased to 40 mg.
Since that day, the head pressure has been present every day and has never completely resolved.
The intensity fluctuates throughout the day, usually ranging from 2–3/10 at its best to 8–9/10 at its worst, but there is always a baseline level of pressure.
The pressure involves my entire head rather than one specific location. It is a constant pressure sensation rather than a throbbing headache.
The only time I experience relief is when I am asleep. As soon as I wake up, the head pressure returns.
Associated Symptoms
Significant short-term memory impairment
Poor concentration and attention
Difficulty following conversations
Word-finding and speech difficulties
I do not typically experience:
Photophobia
Phonophobia
Nausea or vomiting
Aura
Because of these features, I personally do not feel that my symptoms resemble a typical migraine.
Medication History
After the head pressure began, I later returned to a higher dose of olanzapine. The head pressure became less severe but never disappeared completely.
I have also tried several migraine medications, including Ubrelvy and Nurtec, without benefit.
Previous Evaluation
Brain CT: Normal
Brain MRI: Normal
Routine blood work: Unremarkable