NDPH
Free to print
Is the new preventive actually working?
A daily headache makes it hard to tell. Write down where you are before you start, then spend one minute a week on this sheet. After twelve weeks you and your doctor will have an answer instead of a guess.
One page, landscape, A4 or US Letter. Use a new sheet for each medicine or treatment.
Preventive trial trackerOne sheet per treatment · fill in one row a week
Name Medicine / treatment Prescribed by
Start date Target dose Review on
Before I start — the 4 weeks before the first dose (your calendar helps)
Headache-free days
Severe days
Usual pain, 0–10
Painkiller days
Days missed (work, school, plans)
Week by week
| Week | Dates | Dose this week | Headache-free days0–7 | Severe days0–7 | Usual pain0–10 | Painkiller days0–7 | Missed doses | Side effects · notes |
|---|---|---|---|---|---|---|---|---|
| 1 | ||||||||
| 2 | ||||||||
| 3 | ||||||||
| 4 | ||||||||
| 5 | ||||||||
| 6 | ||||||||
| 7 | ||||||||
| 8 | ||||||||
| 9 | ||||||||
| 10 | ||||||||
| 11 | ||||||||
| 12 |
At week 12 — add up the last 4 weeks (weeks 9–12) and compare
| Before | Weeks 9–12 | Better / same / worse | |
|---|---|---|---|
| Headache-free days | |||
| Severe days | |||
| Usual pain | |||
| Painkiller days |
The decision — with your doctor
keep goingraise the dosegive it longerstop and try something else
Why:
With a constant headache, the number of headache days may never change. Fewer severe days, lower usual pain or fewer painkiller days can still mean a treatment is helping.
Free from ndph.org · keep this with your headache historyNever stop or change a medicine without talking to your doctor. Not a diagnostic tool.
How to use it
- Fill in “before I start” first. Without a baseline, it is almost impossible to judge a treatment honestly three months later. Your year calendar gives you the numbers.
- One row a week, same day each week. Count from your calendar or diary rather than from memory.
- Agree with your doctor on what “severe” means for you — for example, a day you had to stop what you were doing.
- Give it time. Preventives are usually started at a low dose and raised slowly. Many specialists want two to three months at an adequate dose before calling one a failure, and NDPH often needs several attempts.7,40
- Side effects matter too. Write them down even if they seem small; they are often the reason a treatment is stopped, and a dose change can sometimes fix them.
- Keep the finished sheets. They become the treatment table in your headache history, so the next doctor doesn’t suggest something that has already failed.
References
Numbers in the text link to these sources. Where the evidence comes from migraine rather than NDPH, the text says so.
- Cheema S, Mehta D, Ray JC, Hutton EJ, Matharu MS. New daily persistent headache: a systematic review and meta-analysis. Cephalalgia 2023;43(5):3331024231168089. doi.org/10.1177/03331024231168089
- Yamani N, Olesen J. New daily persistent headache: a systematic review on an enigmatic disorder. J Headache Pain 2019;20:80. doi.org/10.1186/s10194-019-1022-z