Benzylpiperazine (BZP), Unremitting Headache and Aggresive Treatment

Thanks for taking the time to read my headache (migraine?) story.

Six months ago I (very, very foolishly) took a BZP-based, so-called ‘party pill’. 1-Benzylpiperazine (BZP) has a peripheral sympathomimetic action and a complex central action, both directly and indirectly acting upon on all monoamine. On top of a central and probably peripheral amphetamine-like action, BZP is thought to be an agonist of the 5-HT2B receptor. Mild ‘hangover’ headaches are reported in the limited literature on this drug, but nothing more. I briefly developed a severe headache that night, which passed. A few days later, however, I began to experience an unremitting, tension/pressure-headache that is bilateral, non-pulsating, and ever-present. Six months later it is still there: unremitting, chronic pain. It can vary in intensity but never goes away. I am a 35-year old man with no history of headaches and am otherwise healthy. My MRI showed no structural abnormalities.

My neurologist has diagnosed a migraine-type headache and, as is standard, recommended that all OTC medication cease (I was not taking too many in any case). He is, again as protocol dictates, moving through the standard array of prophylactics. As amitrlyline (25 mg) had no efficacy as a preventative, he has prescribed an anti-convulsant: epilim chrono. I am at 600mg per day. No efficacy to date. He has also suggested an IV infusion of DHE to try to ‘break’ the headache cycle. Like many people, I am increasingly skeptical of the efficacy of prevention meds but understand the logic behind the curtailment of abortives.

I have two questions:

(1) Has anyone any comment on an alternative potential response to this problem given what would appear to be a clear cause?

(2) Is a more aggressive treatment called for?

Thanks again for taking the time. All comments welcome.

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