[25F] Experiencing severe headache, dizziness, and anxiety

Patient Description

A 25-year-old female presents with a severe, throbbing headache that began at the base of the skull and radiates to the temples, rated 6-7 out of 10 in intensity. The headache has persisted for 3 days, following a migraine experienced 4 days prior. Accompanying symptoms include lightheadedness, dizziness, nausea, and a sensation of heart pounding, which has been a long-standing issue but has worsened with recent stress. The patient has a history of anxiety, which has been well-managed over the past 7 years, but current health concerns have led to increased panic. No fever, neck stiffness, rash, confusion, seizure, weakness, numbness, or trouble speaking were reported. The patient is currently taking Vraylar and Vyvanse, with a past episode of an unexplained seizure a few years ago. No known drug allergies or recent changes in medication or substance use have been reported, except for an ongoing effort to quit vaping. The patient occasionally experiences high blood pressure and low blood sugar, but has not been formally diagnosed with hypertension or hypoglycemia.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Migraine: Your throbbing headache, which starts at the base of your skull and radiates into your temples, along with nausea, could be a sign of a migraine. Migraines are severe headaches that can cause a pulsing or throbbing sensation, usually on one side of the head. They can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

    • Treatment often involves medications to help reduce the frequency and severity of migraines. Lifestyle changes, such as managing stress and avoiding certain foods, can also help.
  • Anxiety: Your feelings of panic and a racing heart could be related to anxiety. Anxiety disorders are a group of mental health conditions that cause excessive fear, worry, or unease. These feelings can interfere with daily activities and may be difficult to control.

    • Treatment for anxiety often involves psychotherapy (talk therapy), medications, or a combination of both.
  • Side effects of medication: Vyvanse, a medication you're taking, can cause side effects such as headaches, dizziness, and a racing heart. Vraylar, another medication you're taking, can also cause headaches as a side effect.

    • If you suspect your symptoms are due to your medication, it's important to talk to your doctor. They may adjust your dose or switch you to a different medication.

What you can do

  1. Keep a headache diary: This can help you identify triggers for your migraines, such as certain foods, stress, or changes in your sleep pattern.
  2. Practice stress management: Techniques such as deep breathing, meditation, and yoga can help reduce anxiety and may also help with migraine prevention.
  3. Stay hydrated and maintain a healthy diet: Dehydration and certain foods can trigger migraines.
  4. Regular exercise: Physical activity can help reduce anxiety and improve mood. It may also help prevent migraines.
  5. Consult your doctor: If your headaches continue or get worse, or if your anxiety is interfering with your daily life, it's important to seek medical advice. Your doctor can provide a formal diagnosis and discuss treatment options with you.

What you should look out for

Seek immediate medical attention if you experience:

  • A sudden, severe headache like a thunderclap
  • Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or trouble speaking
  • Headache after a head injury, especially if the headache gets worse
  • A chronic headache that is worse after coughing, exertion, straining, or a sudden movement
  • New headache pain if you're over 50

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare professional for an accurate diagnosis and treatment.

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10 mo ago

People Also Ask


What are common triggers for migraines and how can they be managed?

Common triggers for migraines include stress, certain foods (like aged cheese and processed meats), caffeine, alcohol, changes in sleep patterns, and hormonal changes. Managing these triggers involves identifying them through a headache diary, avoiding known triggers, maintaining a regular sleep schedule, and practicing stress management techniques.


How can anxiety contribute to physical symptoms like headaches and a racing heart?

Anxiety can lead to physical symptoms such as headaches and a racing heart due to the body's 'fight or flight' response, which releases stress hormones like adrenaline. This can cause increased heart rate, muscle tension, and heightened sensitivity to pain, contributing to headaches.


What are the potential side effects of Vyvanse and Vraylar that could relate to my symptoms?

Vyvanse can cause side effects such as headaches, dizziness, and increased heart rate. Vraylar may also cause headaches. If you suspect these medications are contributing to your symptoms, it's important to discuss this with your doctor, who may adjust your dosage or suggest alternative treatments.


What lifestyle changes can help in managing both migraines and anxiety?

Lifestyle changes that can help manage migraines and anxiety include regular exercise, maintaining a healthy diet, staying hydrated, practicing relaxation techniques like yoga or meditation, and ensuring adequate sleep. These changes can help reduce the frequency and severity of migraines and improve overall mental health.


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