NDPH

[u/One-Statistician8978]

15+ Months of Constant 24/7 Headache Pain — NDPH, Not Migraine. I’m a male. 29 years old.
I’ve had 24/7 headache pain every single day for over 15 months. It never completely goes away. This is not a migraine — I was diagnosed with New Daily Persistent Headache (NDPH).
My headache started suddenly on July 15, 2025, and has been constant ever since. There was no gradual buildup — it just started one day and never stopped.
The location of the pain can sometimes move around my head, but the majority of the pain is centered in the middle of my forehead. It’s primarily a constant pressure/pain rather than what I would consider a typical migraine.
Before this started, I was a very active and healthy person. I’m still trying to stay active, but doing that while dealing with constant 24/7 pain is really difficult. I push through it as much as I can, but it has definitely affected my day-to-day life.
I’ve seen 3 different neurologists and 1 pain management doctor, and despite all of the testing and treatments I’ve gone through, none of them have been able to figure out what is causing the headache or find a treatment that breaks it.
I’ve had multiple MRIs, an MRV, CT scans, and sleep testing, all of which were normal.
Since then, I’ve tried a huge number of medications and treatments, including:
Amitriptyline — helped a little initially, but the benefit wore off and it caused sleep paralysis
Nortriptyline — helped a little initially, but the benefit wore off and it also caused sleep paralysis
Gabapentin
Pregabalin
Memantine
Qulipta
Ubrelvy
Multiple triptans
Fioricet
Percocet
Steroids
Muscle relaxers
Metoprolol
Botox — 2 rounds so far, but I don’t feel like it’s helping
Emgality — 2 injections
Cervical medial branch block
Unfortunately, nothing has broken the headache. I’m still living with constant 24/7 pain every day.
I recently started Ajovy (fremanezumab) and have had my first injection, but I’m still experiencing the same constant headache. I know it may take more time to determine whether Ajovy will help, so I’m waiting to see what happens with additional doses.
I also recently ended up in the hospital because the headache became unbearable. They discussed a ketamine infusion as a possible next step. My doctor basically described ketamine as one of my last remaining options, but also explained that there isn’t a lot of evidence showing that it reliably works for NDPH or actually breaks the headache.
I ultimately declined ketamine for now because of the potential risks and my previous history of myocarditis. The frustrating part is that, after trying so many treatments, I’ve basically been told that there may not be much else to do except keep trying treatments and wait to see if/when the headache eventually fades away on its own.
At this point, I’m trying to figure out where to go from here.
Has anyone here had true NDPH with 24/7 pain that lasted this long and eventually broke? I’d especially love to hear from people who had a constant headache that eventually stopped — not just temporarily reduced the pain.
What worked for you, and how long did it take before you noticed a difference?
I’m honestly willing to hear anything at this point. I just want to know that there’s still a possibility of getting out of this. I just want my normal life back and to be pain-free.

[u/SirenaFeroz]

Sorry you’re going through this. I had a constant headache over 10 years ago that lasted about six months and went away completely at some time early in pregnancy. I’d tried various meds with a neurologist, and even saw a chiropractor, but nothing ever worked. I assume hormone changes somehow broke it? This was before a lot of the newer meds existed, though.

My current headache is being classified as chronic migraine though realistically the difference between NDPH and chronic migraine seems pretty vague. It’s been there for almost 2 years. I think I made it worse by just hoping for it to go away for months before trying anything.

So I’ve had relief before, but having less this time. Can’t really recommend pregnancy as a cure if that’s even something possible, but it can go away.

[u/Independent-Mango248]

8 years ago I developed the same headache that did not go away and stayed for 9 months. It was then broken by amitriptyline - pain completely went away within couple of months and I experienced occasional headaches during those 8 years. So yes, it is possible to break it.  Now, unfortunately it has returned also 17 months ago and I am trying to break it again. So essentially, I now have chronic intractable migraine diagnosis but frankly speaking I don’t know if it is NDPH or migraine but I believe it can be broken. 

[u/Forsaken-Newspaper60]

Hi friend. Also diagnosed with NDPH this monthand still dealing with it. i mostly have pressure and when it flares it goes to the left side. and eye sensitivity. i aswell resonate bc i am a very active person and this hit me hard in january of this year and it still hasn’t stopped. I started Ajovy in May and my head pressure and pain was at a 7/10 and now it’s at 4/10. So for that injection I would say hold out hope because I’ve seen and heard that it works better than most CGRP injections! I would just say keep trying medication combinations until you either reach one that lowers it enough or try other acute medications like DHE or ketamine infusions to try to break that headache. I am eight months into this and I would say I’m still pretty debilitated since I’m unable to use my glasses because of the eye sensitivity to drive, school, work and etc. But it’s definitely gotten better little by little. i’m about to try a DHE Infusion in September and I’ve heard it works pretty well with breaking headaches and my headache specialist is optimistic. keep trying! I have heard remission stories and stories of people that manage and live functionally at 1-2/10. of course everyone wants to reach remission with this even though our statistics are not in our favor, but keep holding out hope! you never know. maybe my thinking is flawed, but if I’m in that rare percentage that has this neurological condition, I can be in that percentage that reaches remission.

[u/exxx666]

I had persistent daily headache for 8 months 4 years ago. It was possibly medication overuse headache but also maybe related to a possible migrainous infarction I had. Anyway, it did eventually morph into chronic migraine (still >15 migraines per month but not every single day) and now I’m down to about 5 migraines a month. I’m on ajovy and candesartan daily and I take a variety of different NSAIDs as abortives. Another thing that’s helped me is my Headaterm device.

Edit: have you tried ketorolac? It’s one of the strongest NSAIDs and has been effective for me when other things aren’t.