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Desvenlafaxine

New Insights into New Daily Persistent Headache: Study Reveals Limited Effectiveness of Treatments

Strategic Insights

— 2 min read

A team of investigators from the Department of Neurology has published a new study on new daily persistent headache (NDPH), a primary headache disorder characterized by the abrupt onset of continuous and unremitting headache within 24 hours of onset. The study, which involved a retrospective chart review of 328 patients diagnosed with NDPH, found that nonspecific white matter hyperintensities (WMH) were present in a minority of patients, and acute treatments were largely ineffective. Preventive treatments, however, showed some effectiveness, particularly in those with the migraine phenotype.

Key Takeaways:

  • The study assessed the prevalence of WMH and treatment response in a large retrospective cohort with primary NDPH, which consisted of 328 patients diagnosed by a headache subspecialist over an 8.5-year period.
  • Patients were classified into the migraine phenotype (MP; n = 260) or tension-type phenotype (TTP; n = 50) based on associated features.
  • WMH were reported in 20.9% of MP patients (33/158) and 18.0% of TTP patients (9/50), with no significant difference between the two groups.
  • Acute treatments for the MP and TTP were minimally, if at all, effective.
  • Preventive treatments generally had limited effectiveness, but showed some effectiveness in those with the MP.
  • Desvenlafaxine, venlafaxine, and onabotulinumtoxinA were the most effective treatments for the MP, with percentages of patients achieving a 30% or greater reduction in headache days per month being 54.5%, 41.2%, and 27.9%, respectively.
  • Venlafaxine was the most effective treatment for the TTP, with 25% of patients experiencing a 30% or greater reduction in headache days.
  • Greater occipital and pericranial nerve blocks were mildly effective, while surgical procedures were largely ineffective.
  • Up to five-day inpatient intravenous regimens with dihydroergotamine produced temporary benefit in 41.7% of patients.

Statistics:

  • 328 patients were included in the retrospective chart review.
  • 260 patients had the migraine phenotype (MP), while 50 patients had the tension-type phenotype (TTP).
  • 33.9% of MP patients and 18.0% of TTP patients had WMH.
  • 41.7% of patients experienced temporary benefit from up to five-day inpatient intravenous regimens with dihydroergotamine.

Sources:

  • NewsRx. Department of Neurology Researchers Update Current Data on Headache (Treatment response and white matter hyperintensities in 328 patients with new daily persistent headache: A retrospective real-world study). Health & Medicine Week. October 31, 2025; p 763.
  • Treatment response and white matter hyperintensities in 328 patients with new daily persistent headache: A retrospective real-world study. Cephalalgia Reports, 2025,8. The publisher for Cephalalgia Reports is SAGE Publishing.

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