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Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 28 січня 2023

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1

Scher, Ann I., Paul B. Rizzoli, and Elizabeth W. Loder. "Medication overuse headache." Neurology 89, no. 12 (August 18, 2017): 1296–304. http://dx.doi.org/10.1212/wnl.0000000000004371.

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Анотація:

It is a widely accepted idea that medications taken to relieve acute headache pain can paradoxically worsen headache if used too often. This type of secondary headache is referred to as medication overuse headache (MOH); previously used terms include rebound headache and drug-induced headache. In the absence of consensus about the duration of use, amount, and type of medication needed to cause MOH, the default position is conservative. A common recommendation is to limit treatment to no more than 10 or 15 days per month (depending on medication type) to prevent headache frequency progression. Medication withdrawal is often recommended as a first step in treatment of patients with very frequent headaches. Existing evidence, however, does not provide a strong basis for such causal claims about the relationship between medication use and frequent headache. Observational studies linking treatment patterns with headache frequency are by their nature confounded by indication. Medication withdrawal studies have mostly been uncontrolled and often have high dropout rates. Evaluation of this evidence suggests that only a minority of patients required to limit the use of symptomatic medication may benefit from treatment limitation. Similarly, only a minority of patients deemed to be overusing medications may benefit from withdrawal. These findings raise serious questions about the value of withholding or withdrawing symptom-relieving medications from people with frequent headaches solely to prevent or treat MOH. The benefits of doing so are smaller, and the harms larger, than currently recognized. The concept of MOH should be viewed with more skepticism. Until the evidence is better, we should avoid dogmatism about the use of symptomatic medication. Frequent use of symptom-relieving headache medications should be viewed more neutrally, as an indicator of poorly controlled headaches, and not invariably a cause.

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2

Beckmann, Yesim, Sevgin Gökçe, Nabi Zorlu, H. Sabiha Türe, and Fazıl Gelal. "Longitudinal assessment of gray matter volumes and white matter integrity in patients with medication-overuse headache." Neuroradiology Journal 31, no. 2 (January 31, 2018): 150–56. http://dx.doi.org/10.1177/1971400918756374.

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Background Medication-overuse headache is a common clinical entity, but neuroimaging studies investigating volumetric and microstructural alterations of the brain in medication-overuse headache are rare. Therefore, in the current longitidunal study we evaluated gray matter volume and white matter integrity in patients with medication-overuse headache before and after drug withdrawal. Methods A prospective study evaluated 27 patients with medication-overuse headache and 27 age-, sex-, and education-matched healthy adults. High-resolution T1-weighted magnetic resonance imaging and diffusion tensor imaging were obtained from the control group and medication-overuse headache patients before and six months after drug withdrawal. Tract-based spatial statistics of multiple diffusivity indices and voxel-based morphometry were employed to investigate white and gray matter abnormalities. Results No correlation was found between age, gender, education and smoking status in both groups. The most commonly overused medications were simple analgesics (96.3%) and combined analgesics (3.7%). The mean duration of the history of medication overuse and headaches was 56.7 ± 63.5 months. White matter diffusional and gray matter morphological alterations including volume, fractional anisotropy, radial diffusivity, and axial diffusivity analyses showed no significant relationship in the patients before and six months after withdrawal of analgesics. Also no difference was observed between the patients versus controls. Conclusion Our data demonstrated no structural alterations within the brain in medication-overuse headache.

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3

Park, Hong-Kyun, and Soo-Jin Cho. "Comprehensive approach for the treatment of medication-overuse headache." Journal of the Korean Medical Association 64, no. 12 (December 10, 2021): 843–51. http://dx.doi.org/10.5124/jkma.2021.64.12.843.

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Background: Medication-overuse headache (MOH) is defined by the International Classification of Headache Disorders as a headache in patients with a pre-existing primary headache disorder that occurs on 15 or more days per month for more than 3 months. It is caused by overuse of medication for acute or symptomatic headache treatment. Regular and frequent use of acute or symptomatic medications can worsen headaches and lead to chronic headache or MOH. MOH is a burdensome medical condition that is difficult to treat, and the frequent recurrence of headaches may result in disability in individuals and impair socioeconomic outcomes.Current Concepts: Awareness of MOH and the education of patients, the general population, and healthcare providers are important for the first step of treatment. Scientific research regarding the treatment of MOH has been published in the past few years.Discussion and Conclusion: Physicians should educate and counsel patients to stop or at least reduce the intake of acute or symptomatic medications that can be discontinued abruptly or tapered slowly. During the period after the discontinuation of the overused medications, some withdrawal symptoms including headache might be manageable with bridging therapy. Evidence-based preventive therapies including anticonvulsants (topiramate and divalproex sodium), botulinum toxin A, and medications acting by antagonism of the calcitonin generelated peptide pathway might be helpful in patients with MOH for both avoiding the overused medication and preventing the relapse of overuse. A comprehensive and multidisciplinary approach may improve the outcomes of patients with MOH.

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4

Chiang, Chia-Chun, Todd J. Schwedt, Shuu-Jiun Wang, and David W. Dodick. "Treatment of medication-overuse headache: A systematic review." Cephalalgia 36, no. 4 (June 29, 2015): 371–86. http://dx.doi.org/10.1177/0333102415593088.

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Introduction The objective of this review is to provide an evidence-based discussion of different treatment strategies for medication-overuse headache (MOH). Method We searched PubMed for articles discussing the treatment and prognosis of MOH published between 2004 and August 2014. Titles, abstract and articles were reviewed systematically. The level of evidence provided by each study of the included articles was determined according to the American Academy of Neurology Clinical practice guideline manual. We discuss the level of evidence to support the early discontinuation/withdrawal of overused medications, the level of evidence to support the use of preventive treatment, the short- and long-term prognosis, and the outcome according to the class of drug overused in patients diagnosed with MOH. Results The initial search resulted in 1313 articles; 68 articles met our inclusion criteria and were discussed. The level of evidence to support early discontinuation of overused medications alone is low due to the absence of controlled studies. Adding preventive medication to early discontinuation led to a better outcome than early discontinuation alone. For patients with chronic migraine (CM) and medication overuse (MO), there are large randomized control trials supporting the use of onabotulinumtoxinA and topiramate without early discontinuation of overuse; however, the evidence is limited since data were obtained from post hoc analysis. Conclusion Considering current available evidence and the systemic toxicity of overusing acute headache medication, we suggest discontinuation of the overused medication with the addition of preventive medication. Appropriately sized, randomized controlled trials evaluating the safety and long-term efficacy of preventive medication plus early discontinuation of overuse vs preventive medication alone vs early discontinuation of overuse alone are needed.

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5

Schwedt, Todd J., Joseph G. Hentz, Soma Sahai-Srivastava, Natalia Murinova, Nicole M. Spare, Christina Treppendahl, Vincent T. Martin, et al. "Patient-Centered Treatment of Chronic Migraine With Medication Overuse." Neurology 98, no. 14 (February 15, 2022): e1409-e1421. http://dx.doi.org/10.1212/wnl.0000000000200117.

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Background and ObjectivesOveruse of symptomatic (i.e., acute) medications is common among those with chronic migraine. It is associated with developing frequent headaches, medication side effects, and reduced quality of life. The optimal treatment strategy for patients who have chronic migraine with medication overuse (CMMO) has long been debated. The study objective was to determine whether migraine preventive therapy without switching or limiting the frequency of the overused medication was noninferior to migraine preventive therapy with switching from the overused medication to an alternative medication that could be used on ≤2 d/wk.MethodsThe Medication Overuse Treatment Strategy (MOTS) trial was an open-label, pragmatic clinical trial, randomizing adult participants 1:1 to migraine preventive medication and (1) switching from the overused medication to an alternative used ≤2 d/wk or (2) continuation of the overused medication with no maximum limit. Participants were enrolled between February 2017 and December 2020 from 34 clinics in the United States, including headache specialty, general neurology, and primary care clinics. The primary outcome was moderate to severe headache day frequency during weeks 9 to 12 and subsequently during weeks 1 to 2 after randomization.ResultsSeven hundred twenty participants were randomized; average age was 44 (SD 13) years; and 87.5% were female. At baseline, participants averaged 22.5 (SD 5.1) headache days over 4 weeks, including 12.8 (SD 6.7) moderate to severe headache days and 21.4 (SD 5.8) days of symptomatic medication use. Migraine preventive medication without switching of the overused medication was not inferior to preventive medication with switching for moderate to severe headache day frequency during weeks 9 to 12 (switching 9.3 [SD 7.2] vs no switching 9.1 [SD 6.8]; p = 0.75, 95% CI −1.0 to 1.3). The treatment strategies also provided similar outcomes during the first 2 weeks (switching 6.6 [SD 3.7] moderate to severe headaches days vs no switching 6.4 [SD 3.6]; p = 0.57, 95% CI −0.4 to 0.7).DiscussionWhen reduction in moderate to severe headache days was used as the outcome of interest for the management of CMMO, migraine preventive medication without switching or limiting symptomatic medication is not inferior to migraine preventive medication with switching to a different symptomatic medication with a maximum limit of 2 treatment days per week.Trial Registration InformationClinicalTrials.gov identifier NCT02764320.Classification of EvidenceThis study provides Class III evidence that, for patients who have CMMO, migraine preventive medication without switching or limiting the overused medication is noninferior to migraine preventive medication with switching and limiting symptomatic medication.

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6

Schwedt, Todd J., Dawn C. Buse, Charles E. Argoff, Michael L. Reed, Kristina M. Fanning, Cory R. Hussar, Aubrey Manack Adams, and Richard B. Lipton. "Medication Overuse and Headache Burden." Neurology: Clinical Practice 11, no. 3 (January 25, 2021): 216–26. http://dx.doi.org/10.1212/cpj.0000000000001037.

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ObjectiveTo estimate the relative frequency of acute medication overuse (AMO) among people with episodic migraine and chronic migraine, to characterize the types of acute medications overused for migraine, and to identify factors associated with AMO.MethodsWe analyzed data from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study (ClinicalTrials.gov, NCT01648530), a cross-sectional and longitudinal internet study that included a systematic sampling of the US population. From September 2012 to November 2013, the CaMEO Study respondents participated in different modules to collect data on the clinical course of migraine, family burden, barriers to care, endophenotypes, and comorbidities. Among people who met the criteria for migraine consistent with the International Classification of Headache Disorders, third edition (ICHD-3), we evaluated types and frequency of medications used for headache/migraine, selected comorbidities, and emergency department (ED) and urgent care (UC) use. AMO was defined by days per month of medication use as specified by ICHD-3 criteria for medication overuse headache (MOH) without the requirement for ≥15 monthly headache days (MHDs). Nested, multivariable binary logistic regression modeling was used to identify factors associated with an increased risk of AMO.ResultsOf 16,789 CaMEO respondents with migraine, 2,975 (17.7%) met the AMO criteria. Approximately 67.9% (2,021/2,975) of AMO respondents reported <15 MHDs. Simple analgesics, combination analgesics, and opioids were the medication classes most commonly overused. Factors associated with AMO in the final multivariable logistic regression model included ≥15 MHDs, moderate to severe disability, severe migraine interictal burden, use of preventive medication, and an ED/UC visit for headache within 6 months.ConclusionsApproximately two-thirds of respondents with AMO reported <15 MHDs and therefore did not meet the criteria for MOH. Those with AMO had greater disease burden and increased ED/UC utilization relative to people with migraine but not AMO.

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7

Rahman, A., R. Habib, NB Bhowmik, and A. Haque. "Medication Overuse Headache: A Trap for the Headache Patients." BIRDEM Medical Journal 3, no. 2 (December 1, 2013): 94–98. http://dx.doi.org/10.3329/birdem.v3i2.17213.

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Medication Overuse Headache (MOH) was previously termed analgesic rebound headache, drug-induced headache, and medication-misuse headache. It is not a primary headache but frequently coexists with primary chronic daily headache. All acute symptomatic medications used to treat headaches have the potential for causing MOH. Highest with opioids, butalbital-containing combination analgesics, and aspirin/ acetaminophen/caffeine combinations. The development is typically preceded by an episodic headache disorder, usually migraine or tension-type headache, that has been treated with frequent and excessive amounts of acute symptomatic medications. The diagnosis is based upon clinical impression. A history of analgesic use averaging more than two to three days per week in association with chronic daily headache is suggestive. The diagnosis is made when the pattern of frequent headaches fulfills the diagnostic criteria for MOH. The basic steps in the management: Patient education, withdrawal of the offending medication, bridge (transitional) therapy, establishment of a headache treatment regimen covering acute and preventive care, follow up and relapse prevention. Birdem Med J 2013; 3(2): 94-98 DOI: http://dx.doi.org/10.3329/birdem.v3i2.17213

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8

Carlsen, Louise Ninett, Maria Lurenda Westergaard, Mette Bisgaard, Julie Brogaard Schytz, and Rigmor Højland Jensen. "National awareness campaign to prevent medication-overuse headache in Denmark." Cephalalgia 38, no. 7 (October 10, 2017): 1316–25. http://dx.doi.org/10.1177/0333102417736898.

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Background Medication-overuse headache is prevalent, but in principle preventable. Objective To describe the Danish national awareness campaign for medication-overuse headache. Methods The Danish Headache Center, the Association of Danish Pharmacies, and headache patient organizations implemented a four-month medication-overuse headache awareness campaign in 2016. Target groups were the general public, general practitioners, and pharmacists. Key messages were: Overuse of pain-medication can worsen headaches; pain-medication should be used rationally; and medication-overuse headache is treatable. A range of communication technologies was used. A survey on the public’s awareness of medication-overuse headache was conducted. Results The Danish adult population is 4.2 million. Online videos were viewed 297,000 times in three weeks. All 400 pharmacies received campaign materials. Over 28,000 leaflets were distributed. Two radio interviews were conducted. A television broadcast about headache reached an audience of 520,000. Forty articles were published in print media. Information was accessible at 32 reputable websites and five online news agencies. Three scientific papers were published. Information was available at an annual conference of general practitioners, including a headache lecture. The survey showed an increase in percentage of the public who knew about medication-overuse headache (from 31% to 38%). Conclusion A concerted campaign to prevent medication-overuse headache can be implemented through involvement of key stakeholders.

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9

Wakerley, Benjamin R. "Medication-overuse headache." Practical Neurology 19, no. 5 (July 4, 2019): 399–403. http://dx.doi.org/10.1136/practneurol-2018-002048.

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Medication-overuse headache is defined as headache occurring on more than 15days in a month in people with pre-existing primary headache, and developing as a consequence of regular overuse of acute headache treatments. Medication-overuse headache is common in general neurology clinics and can be difficult to manage. Most patients have a background of migraine, which has slowly transformed over months and years from the episodic to chronic form; with this comes an increased use of acute migraine treatment. This paper identifies who is at risk of developing medication-overuse headache, and reviews preventive measures and current treatment strategies.

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10

Bigal, ME, AM Rapoport, FD Sheftell, SJ Tepper, and RB Lipton. "Transformed Migraine and Medication Overuse in a Tertiary Headache Centre — Clinical Characteristics and Treatment Outcomes." Cephalalgia 24, no. 6 (June 2004): 483–90. http://dx.doi.org/10.1111/j.1468-2982.2004.00691.x.

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Studies suggest that a substantial proportion of headache sufferers presenting to headache clinics may overuse acute medications. In some cases, overuse may be responsible for the development or maintenance of a chronic daily headache (CDH) syndrome. The objectives of this study are to evaluate patterns of analgesic overuse in patients consulting a headache centre and to compare the outcomes in a group of patients who discontinued medication overuse to those of a group who continued the overuse, in patients with similar age, sex and psychological profile. We reviewed charts of 456 patients with transformed migraine (TM) and acute medication overuse defined by one of the following criteria: 1. Simple analgesic use (> 1000 mg ASA/acetaminophen) > 5 days/week; 2. Combination analgesics use (caffeine and/or butalbital) > 3 tablets a day for > 3 days a week; 3. Opiate use > 1 tablet a day for > 2 days a week; 4. Ergotamine tartrate use: 1 mg PO or 0.5 mg PR for > 2 days a week. For triptans, we empirically considered overuse > 1 tablet per day for > 5 days per week. Patients who were able to undergo detoxification and did not overuse medication (based on the above definition) after one year of follow-up were considered to have successful detoxification (Group 1). Patients who were not able to discontinue offending agents, or returned to a pattern of medication overuse within one year were considered to have unsuccessful detoxification (Group 2). We compared the following outcomes after one year of follow-up: Number of days with headache per month; Intensity of headache; Duration of headache; Headache score (frequency x intensity). The majority of patients overused more than one type of medication. Numbers of tablets taken ranged from 1 to 30 each day (mean of 5.2). Forty-eight (10.5%) subjects took > 10 tablets per day. Considering patients seen in the last 5 years, we found the following overused substances: Butalbital containing combination products, 48%; Acetaminophen, 46.2%; Opioids, 33.3%; ASA, 32.0%; Ergotamine tartrate, 11.8%; Sumatriptan, 10.7%; Nonsteroidal anti-inflammatory medications other than ASA, 9.8%; Zolmitriptan, 4.6%; Rizatriptan, 1.9%; Naratriptan, 0.6%. Total of all triptans, 17.8%. Of 456 patients, 318 (69.7%) were successfully detoxified (Group 1), and 138 (30.3%) were not (Group 2). The comparison between groups 1 and 2 after one year of follow-up showed a decrease in the frequency of headache of 73.7% in group 1 and only 17.2% in group 2 ( P < 0.0001). Similarly, the duration of head pain was reduced by 61.2% in group 1 and 14.8% in group 2 ( P < 0.0001). The headache score after one year was 18.8 in group 1 and 54 in group 2 ( P < 0.0001). A total of 225 (70.7%) successfully detoxified subjects in Group 1 returned to an episodic pattern of migraine, compared to 21 (15.3%) in Group 2 ( P < 0.001). More rigorous prescribing guidelines for patients with frequent headaches are urgently needed. Successful detoxification is necessary to ensure improvement in the headache status when treating patients who overuse acute medications.

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Green, Mark W. "Medication overuse headache." Current Opinion in Neurology 34, no. 3 (March 11, 2021): 378–83. http://dx.doi.org/10.1097/wco.0000000000000925.

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Walter, Thomas Robert. "Medication Overuse Headache." Journal of Pain & Palliative Care Pharmacotherapy 30, no. 1 (January 2, 2016): 66–68. http://dx.doi.org/10.3109/15360288.2015.1063565.

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Williams, David. "Medication overuse headache." Australian Prescriber 28, no. 6 (December 1, 2005): 143–45. http://dx.doi.org/10.18773/austprescr.2005.109.

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Maksimova, M. Yu, T. Yu Chochlova, and L. A. Mota. "Medication overuse headache." Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova 117, no. 9 (2017): 99. http://dx.doi.org/10.17116/jnevro20171179199-102.

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Kulkarni, GirishBaburao, Thomas Mathew, and Pooja Mailankody. "Medication Overuse Headache." Neurology India 69, no. 7 (2021): 76. http://dx.doi.org/10.4103/0028-3886.315981.

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Katsarava, Zaza, Hans-Christoph Diener, and Volker Limmroth. "Medication Overuse Headache." Drug Safety 24, no. 12 (2001): 921–27. http://dx.doi.org/10.2165/00002018-200124120-00005.

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Limmroth, Volker, and Zaza Katsarava. "Medication overuse headache." Current Opinion in Neurology 17, no. 3 (June 2004): 301–6. http://dx.doi.org/10.1097/00019052-200406000-00011.

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Katsarava, Zaza, and Mark Obermann. "Medication Overuse Headache." Topics in Pain Management 29, no. 2 (September 2013): 1–7. http://dx.doi.org/10.1097/01.tpm.0000434247.92392.ef.

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Rapoport, Alan M. "Medication Overuse Headache." CNS Drugs 22, no. 12 (2008): 995–1004. http://dx.doi.org/10.2165/0023210-200822120-00003.

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Ward, Thomas N. "Medication overuse headache." Primary Care: Clinics in Office Practice 31, no. 2 (June 2004): 369–80. http://dx.doi.org/10.1016/j.pop.2004.02.008.

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Sheftell, Fred D., and Marcelo E. Bigal. "MEDICATION OVERUSE HEADACHE." CONTINUUM: Lifelong Learning in Neurology 12 (December 2006): 153–69. http://dx.doi.org/10.1212/01.con.0000290528.77697.52.

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Tepper, Stewart J. "Medication-Overuse Headache." CONTINUUM: Lifelong Learning in Neurology 18 (August 2012): 807–22. http://dx.doi.org/10.1212/01.con.0000418644.32032.7b.

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Katsarava, Zaza, and Mark Obermann. "Medication-overuse headache." Current Opinion in Neurology 26, no. 3 (June 2013): 276–81. http://dx.doi.org/10.1097/wco.0b013e328360d596.

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Pageler, Lutz, Irini Savidou, and Volker Limmroth. "Medication-overuse headache." Current Pain and Headache Reports 9, no. 6 (December 2005): 430–35. http://dx.doi.org/10.1007/s11916-005-0023-6.

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Obermann, Mark, Thorsten Bartsch, and Zaza Katsarava. "Medication overuse headache." Expert Opinion on Drug Safety 5, no. 1 (December 22, 2005): 49–56. http://dx.doi.org/10.1517/14740338.5.1.49.

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Haag, Gunther. "Medication overuse headache." Expert Opinion on Drug Safety 6, no. 2 (March 2007): 97–98. http://dx.doi.org/10.1517/14740338.6.2.97.

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Louter, Mark A., Matthew S. Robbins, and Gisela M. Terwindt. "Medication overuse headache." Neurology 89, no. 12 (August 18, 2017): 1206–7. http://dx.doi.org/10.1212/wnl.0000000000004374.

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Tepper, Stewart J. "Medication Overuse Headache." Headache: The Journal of Head and Face Pain 54, no. 1 (January 2014): 203. http://dx.doi.org/10.1111/head.12222.

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Munksgaard, Signe B., and Rigmor H. Jensen. "Medication Overuse Headache." Headache: The Journal of Head and Face Pain 54, no. 7 (July 2014): 1251–57. http://dx.doi.org/10.1111/head.12408.

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Tepper, Deborah. "Medication Overuse Headache." Headache: The Journal of Head and Face Pain 57, no. 5 (April 26, 2017): 845–46. http://dx.doi.org/10.1111/head.13034.

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Micieli, Andrew, and Jennifer Robblee. "Medication-overuse headache." Canadian Medical Association Journal 190, no. 10 (March 11, 2018): E296. http://dx.doi.org/10.1503/cmaj.171101.

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Diener, Hans-Christoph, and Zaza Katsarava. "Medication Overuse Headache*." Current Medical Research and Opinion 17, sup1 (January 2001): s17–21. http://dx.doi.org/10.1185/0300799039117003.

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Katsarava, Zaza, Dagny Holle, and Hans-Christoph Diener. "Medication overuse headache." Current Neurology and Neuroscience Reports 9, no. 2 (March 2009): 115–19. http://dx.doi.org/10.1007/s11910-009-0019-4.

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Young, William B. "Medication overuse headache." Current Treatment Options in Neurology 3, no. 2 (March 2001): 181–88. http://dx.doi.org/10.1007/s11940-001-0053-2.

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Jelinski, SE, WJ Becker, SN Christie, R. Giammarco, GF Mackie, MJ Gawel, AG Eloff, and JE Magnusson. "Clinical Features and Pharmacological Treatment of Migraine Patients Referred to Headache Specialists in Canada." Cephalalgia 26, no. 5 (May 2006): 578–88. http://dx.doi.org/10.1111/j.1468-2982.2005.01077.x.

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We set out to examine selected clinical characteristics of migraine patients referred to neurologists specializing in headache in Canada, and to document their pharmacological therapy both before and after consultation with the neurologist. Demographic, clinical and pharmacotherapy data were collected at the time of consultation for 606 patients referred to five headache clinics and who were given a migraine diagnosis by the neurologist. Data were analysed as part of the Canadian Headache Outpatient Registry and Database (CHORD) Project. The mean age of the migraine patients was 39.7 years; and 82.5% were female. The majority of patients suffered severe impact from their headaches. Prior to consultation, 48.7% were taking a triptan; after consultation, 97.2% were on a triptan. Before consultation, 30.9% were on a prophylactic drug; after consultation, 70.4% were. 20.8% of patients were medication overusers. Of these medication overusers, 42.4% were overusing an opiate, usually in combination with other analgesics; 21.6% were overusing a triptan. Medication changes made by the neurologists at consultation included a large increase in the use of both triptans and prophylactic medications. Medication overuse, particularly opiate overuse, remains a significant problem in patients with migraine in Canada.

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Salhofer-Polanyi, Sabine, Karin Zebenholzer, Thomas Berndl, Kastriot Kastrati, Sandra Raab, Patricia Schweitzer, Tim Stria, Pavao Topic, and Christian Wöber. "Medication overuse headache in 787 patients admitted for inpatient treatment over a period of 32 years." Cephalalgia 40, no. 8 (March 10, 2020): 808–17. http://dx.doi.org/10.1177/0333102420911210.

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Background Definitions of medication overuse headache have changed over time. Objective To evaluate the clinical characteristics of medication overuse headache patients admitted for inpatient withdrawal therapy over a period of 32 years. Methods We included all patients with medication overuse headache treated from 1 January 1984 to 31 December 2015. We obtained all data from the medical reports and defined three periods, P1 (1984–1993), P2 (1994–2003), and P3 (2004–2015). The p-value adjusted for multiple comparisons was set to 0.005. Results Within 32 years, a total of 787 patients accounted for 904 admissions for MOH. From P1 to P3, the proportion of patients with preexisting migraine increased from 44.3% to 53.3% (chi2 = 9.0, p = 0.01) and that with preexisting tension-type headache decreased from 47.9% to 34.6% (chi2 = 9.3, p < 0.01). The median time since onset of headache and medication overuse headache decreased from 20 to 15 years ( p < 0.001) and from 3 to 2 years ( p < 0.001). The median cumulative number of single doses decreased from 120 to 90 per month ( p = 0.002). Overuse of triptans, non-opioid analgesics, and opioids increased, whereas overuse of ergotamines decreased over time ( p < 0.001 for all tests). The use of prophylactic medication before admission increased from 8.3% to 29.9% (chi2 = 89.5, p < 0.001). Conclusion This retrospective study in a large number of patients with medication overuse headache admitted for inpatient withdrawal therapy over a period of 32 years shows a trend towards changes in the preexisting headache type, a decrease in the time since onset of headache and medication overuse headache, a decrease in the number of drug doses used per month, changes in the type of drugs overused, and an increase in, but still low rate, of prophylactic medication prior to admission.

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Jellestad, Pernille Linde, Louise Ninett Carlsen, Maria Lurenda Westergaard, Signe Bruun Munksgaard, Lars Bendtsen, Miguel Lainez, Ricardo Fadic, et al. "Economic benefits of treating medication-overuse headache – results from the multicenter COMOESTAS project." Cephalalgia 39, no. 2 (July 8, 2018): 274–85. http://dx.doi.org/10.1177/0333102418786265.

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Background Medication-overuse headache is a costly disease for individuals and society. Objective To estimate the impact of medication-overuse headache treatment on direct and indirect headache-related health care costs. Methods This prospective longitudinal study was part of the COMOESTAS project (COntinuous MOnitoring of Medication Overuse Headache in Europe and Latin America: development and STAndardization of an Alert and decision support System). Patients with medication-overuse headache were included from four European and two Latin American headache centers. Costs of acute medication, costs of health care services, and measurements of productivity were calculated at baseline and at 6-month follow-up Treatment consisted of overused drug withdrawal with optional preventive medication. Results A total of 475 patients (71%) completed treatment and were followed up for 6 months. Direct health care costs were on average reduced significantly by 52% ( p < 0.001) for the total study population. Significant reductions were seen in both number of consumed tablets (−71%, p < 0.001) and number of visits to physicians (−43%, p < 0.001). Fifty percent of patients reduced their number of consumed tablets ≥ 80%. Headache-related productivity loss, calculated either as absence from work or ≥ 50% reduction of productivity during the workday, were reduced by 21% and 34%, respectively ( p < 0.001). Conclusion Standardized treatment of medication-overuse headache in six countries significantly reduced direct health care costs and increased productivity. This emphasizes the importance of increasing awareness of the value of treating medication-overuse headache. Trial registration The trial was registered at ClinicalTrials.gov (no. NCT02435056)

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Boes, CJ, and DJ Capobianco. "Chronic Migraine and Medication-Overuse Headache Through the Ages." Cephalalgia 25, no. 5 (May 2005): 378–90. http://dx.doi.org/10.1111/j.1468-2982.2005.00868.x.

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We set out to review early descriptions of chronic migraine and medication-overuse headache. The International Headache Society (IHS) recently gave criteria for chronic migraine and medication-overuse headache. Chronic migraine was absent from the 1988 IHS criteria. Peters and Horton described ergotamine-overuse headache in 1951. In the 1980s it was more fully appreciated that overuse of other acute headache medications could increase headache frequency. We reviewed published English-language papers and book chapters. Willis (1672), Oppenheim (1900), Collier (1922), Balyeat (1933), and von Storch (1937) all described chronic migraine. Lennox (1934), O'Sullivan (1936), Silfverskiöld (1947), Graham (1955), Friedman (1955), and Lippman (1955) wrote about ergotamine-overuse headache. Graham (1955), Friedman (1955), Lippman (1955), and Horton and Peters (1963) outlined withdrawal protocols. Chronic migraine has been mentioned in the literature for centuries, while medication-overuse headache has been written about for decades. Graham, Friedman, and Lippman deserve credit for separately reporting the first ergotamine withdrawal programmes.

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Magyar, Máté, Boglárka Hajnal, Tamás Gyüre, and Csaba Ertsey. "Fájdalomcsillapító-túlhasználathoz társuló fejfájás." Orvosi Hetilap 156, no. 30 (July 2015): 1195–202. http://dx.doi.org/10.1556/650.2015.30209.

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Medication-overuse headache affects 1 to 2 percent of the population. Any kind of painkiller, if taken regularly at least 10 days per month can cause medication-overuse headache, and therefore the possibility of this headache has to be raised whenever a patient with a preexistent headache notices a significant increase in headache frequency during a period of frequent painkiller consumption. Medication-overuse headache is most prevalent in females between 40 and 50 years of age. Its main risk factors are smokig, obesity, depression, and anxiety. The pathomechanism of medication-overuse headache is complex, with a probable genetic propensity and other biological (neurochemical and neurophysiological), as well as psychological and behavioural factors (such as anticipatory anxiety, catastrophisation of pain and consequentially a compulsive painkiller use) contributing to its genesis. The prerequisite of successful treatment is the withdrawal of the overused substance, other necessary elements of the therapy include the treatment of withdrawal symptoms including rebound headache, the introduction of an effective preventative therapy, taking into consideration the highly prevalent comorbid disorders as well, and the education and psychological support of patients. As the relapse rate can be as high as 30 to 40% regardless of effective treatment, the prevention of medication-overuse headache is of paramount importance, and the role of general practitioners can hardly be overstated. Orv. Hetil., 2015, 156(30), 1195–1202.

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Zidverc-Trajkovic, J., T. Pekmezovic, Z. Jovanovic, A. Pavlovic, M. Mijajlovic, A. Radojicic, and N. Sternic. "Medication Overuse Headache: Clinical Features Predicting Treatment Outcome at 1-Year Follow-Up." Cephalalgia 27, no. 11 (November 2007): 1219–25. http://dx.doi.org/10.1111/j.1468-2982.2007.01432.x.

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We present a prospective study of 240 patients with medication overuse headache (MOH) treated with drug withdrawal and prophylactic medications. At 1-year follow-up, 137 (57.1%) patients were without chronic headache and without medication overuse, eight (3.3%) patients did not improve after withdrawal and 95 (39.6%) relapsed developing recurrent overuse. Age at time of MOH diagnosis, regular use of benzodiazepines, frequency and Migraine Disability Assessment (MIDAS) score of chronic headache, age at onset of primary headache, frequency and MIDAS score of primary headache, ergotamine compound overuse and daily drug intake were significantly different between successfully and unsuccessfully treated patients. Multivariate analysis determined the frequency of primary headache disorder, ergotamine overuse and disability of chronic headache estimated by MIDAS as independent predictors of treatment efficacy at 1-year follow-up.

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Westergaard, Maria Lurenda, Cathrine Juel Lau, Karen Allesøe, Signe Thorup Gjendal, and Rigmor Højland Jensen. "Monitoring chronic headache and medication-overuse headache prevalence in Denmark." Cephalalgia 40, no. 1 (September 15, 2019): 6–18. http://dx.doi.org/10.1177/0333102419876909.

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Objectives To study chronic headache and medication-overuse headache (MOH) prevalence; to identify groups with high prevalence of these conditions; and to identify the most frequently used pain medications among respondents with chronic headache. Background Chronic headache and MOH prevalence in Denmark were last estimated in 2010. Methods In this cross-sectional study, 104,950 individuals aged ≥16 years were randomly sampled for the 2017 Danish Capital Region Health Survey. Responses to questions about headache and use of acute pain medications were linked to demographic registries. MOH was defined as headache ≥15 days/month plus self-report of use of pain medications ≥10 or 15 days/month, in the last three months. Weighted prevalence proportions were calculated. Results Among 55,185 respondents, chronic headache prevalence was 3.0% (95% CI: 2.3–3.2) and MOH prevalence was 2.0% (95% CI: 1.8–2.1). Both conditions were more common among females and the middle-aged. Respondents on social welfare or receiving early retirement pensions had the highest prevalences. Among those with chronic headache, 44.7% overused over-the-counter analgesics for headache; paracetamol 41.5%; a combination of different pain relievers 25.3%; ibuprofen 21.9%; opioids 17.0%; combination preparations 14.3%; and triptans 9.1%. Conclusions The highest prevalence of chronic headache and MOH was seen among people with low socioeconomic position. Overuse of paracetamol was most common. Reported opioid use was higher than expected. Groups with high prevalence of MOH should be the focus of public health interventions on rational use of OTC and prescription pain medications.

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Shibata, Mamoru, and Norihiro Suzuki. "5. Medication-overuse Headache." Nihon Naika Gakkai Zasshi 96, no. 8 (2007): 1634–40. http://dx.doi.org/10.2169/naika.96.1634.

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Niddam, David M., Kuan-Lin Lai, Shang-Yueh Tsai, Yi-Ru Lin, Wei-Ta Chen, Jong-Ling Fuh, and Shuu-Jiun Wang. "Brain metabolites in chronic migraine patients with medication overuse headache." Cephalalgia 40, no. 8 (February 25, 2020): 851–62. http://dx.doi.org/10.1177/0333102420908579.

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Background Medication overuse headache may be associated with widespread alterations along the thalamocortical pathway, a pathway involved in pain perception and disease progression. This study addressed whether brain metabolites in key regions of the thalamocortical pathway differed between chronic migraine patients with medication overuse headache and without medication overuse headache. Methods Magnetic resonance spectroscopic imaging was used to map metabolites in the bilateral anterior cingulate cortices, mid cingulate cortices, posterior cingulate cortices, and the thalami. Sixteen patients with medication overuse headache were compared with 16 matched patients without medication overuse headache and 16 matched healthy controls. Results Glutamate and glutamine in the right mid cingulate cortex and myo-inositol in the left anterior cingulate cortex were significantly higher in patients with medication overuse headache than patients without medication overuse headache, but similar to healthy controls. Both patient groups exhibited reduced N-acetyl-aspartate and creatine in the thalamus, reduced myo-inositol in the right anterior cingulate cortex, and elevated choline in the right mid cingulate cortex. Finally, a negative association between myo-inositol laterality index in the anterior cingulate cortices and number of days per month with acute medication use was found across all patients. Conclusions Patients with medication overuse headache were characterized by a distinct concentration profile of myo-inositol, a glial marker, in the anterior cingulate cortices that may have arisen from medication overuse and could contribute to the development of medication overuse headache.

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Couch, James R. "Rebound-withdrawal headache (medication overuse headache)." Current Treatment Options in Neurology 8, no. 1 (February 2006): 11–19. http://dx.doi.org/10.1007/s11940-996-0020-z.

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Relja, G., A. Granato, A. Bratina, RM Antonello, and M. Zorzon. "Outcome of Medication Overuse Headache after Abrupt in-Patient withdrawal." Cephalalgia 26, no. 5 (May 2006): 589–96. http://dx.doi.org/10.1111/j.1468-2982.2006.01073.x.

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One hundred and one patients suffering from chronic daily headache (CDH) and medication overuse were treated, in an in-patient setting, with abrupt discontinuation of the medication overused, intravenous hydrating, and intravenous administration of benzodiazepines and ademetionine. The mean time to CDH resolution was 8.8 days. The in-patient withdrawal protocol used was effective, safe and well tolerated. There was a trend for a shorter time to CDH resolution in patients who overused triptans ( P = 0.062). There was no correlation between time to CDH resolution and either the type of initial primary headache or duration of medication abuse, whereas time to CDH resolution was related to daily drug intake ( P = 0.01). In multiple regression analysis, daily drug intake, age and type of medication overused were independent predictors of time to CDH resolution. At 3-months' follow-up, no patient had relapsed and was again overusing symptomatic medications.

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Cargnin, Sarah, Michele Viana, Grazia Sances, Cristina Tassorelli, and Salvatore Terrazzino. "A systematic review and critical appraisal of gene polymorphism association studies in medication-overuse headache." Cephalalgia 38, no. 7 (September 4, 2017): 1361–73. http://dx.doi.org/10.1177/0333102417728244.

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Purpose of review Medication-overuse headache is a secondary chronic headache disorder, evolving from an episodic primary headache type, caused by the frequent and excessive use of headache symptomatic drugs. While gene polymorphisms have been deeply investigated as susceptibility factors for migraine, little attention has been paid to medication-overuse headache genetics. In the present study we conducted a systematic review to identify, appraise and summarize the current findings of gene polymorphism association studies in medication-overuse headache. Methods A comprehensive literature search was conducted on PubMed and Web of Knowledge databases of primary studies that met the diagnostic criteria for medication-overuse headache according to the temporally-relevant Classification of Headache Disorder of the International Headache Society. Results A total of 17 candidate gene association studies focusing on medication-overuse headache were finally included in the qualitative review. Among these, 12 studies investigated the role of common gene polymorphisms as risk factors for medication-overuse headache susceptibility, six studies focused on the relationship with clinical features of medication-overuse headache patients, and four studies evaluated their role as determinants of clinical outcomes in medication-overuse headache patients. Conclusion Results of single studies show a potential role of polymorphic variants of the dopaminergic gene system or of other genes related to drug-dependence pathways as susceptibility factors for disease or as determinants of monthly drug consumption, respectively. In this systematic review, we summarize the findings of gene polymorphism association studies in medication-overuse headache and discuss the methodological issues that need to be addressed in the design of future studies.

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Sørnes, Elise Øien, Ajay Risal, Kedar Manandhar, Hallie Thomas, Timothy J. Steiner, and Mattias Linde. "Use of medicinal plants for headache, and their potential implication in medication-overuse headache: Evidence from a population-based study in Nepal." Cephalalgia 41, no. 5 (January 12, 2021): 561–81. http://dx.doi.org/10.1177/0333102420970904.

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Background In Nepal, traditional treatment using medicinal plants is popular. Whereas medication-overuse headache is, by definition, caused by excessive use of acute headache medication, we hypothesized that medicinal plants, being pharmacologically active, were as likely a cause. Methods We used data from a cross-sectional, nationwide population-based study, which enquired into headache and use of medicinal plants and allopathic medications. We searched the literature for pharmacodynamic actions of the medicinal plants. Results Of 2100 participants, 1794 (85.4%) reported headache in the preceding year; 161 (7.7%) reported headache on ≥15 days/month, of whom 28 (17.4%) had used medicinal plants and 117 (72.7%) allopathic medication(s). Of 46 with probable medication-overuse headache, 87.0% (40/46) were using allopathic medication(s) and 13.0% (6/46) medicinal plants, a ratio of 6.7:1, higher than the overall ratio among those with headache of 4.9:1 (912/185). Of 60 plant species identified, 49 were pharmacodynamically active on the central nervous system, with various effects of likely relevance in medication-overuse headache causation. Conclusions MPs are potentially a cause of medication-overuse headache, and not to be seen as innocent in this regard. Numbers presumptively affected in Nepal are low but not negligible. This pioneering project provides a starting point for further research to provide needed guidance on use of medicinal plants for headache.

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Androulakis, X. Michelle, Chris Rorden, B. Lee Peterlin, and Kaitlin Krebs. "Modulation of salience network intranetwork resting state functional connectivity in women with chronic migraine." Cephalalgia 38, no. 11 (December 13, 2017): 1731–41. http://dx.doi.org/10.1177/0333102417748570.

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Objective To investigate the intranetwork resting state fMRI connectivity within the Salience Network of chronic migraine with and without medication overuse headache. Methods We compared 351 pairs of intranetwork connectivity in chronic migraine (n = 13) and chronic migraine with medication overuse headache (n = 16) compared to matched controls, and between each chronic migraine subgroup. Results Compared to controls, 17 pairs of intranetwork connections in chronic migraine and 27 pairs in chronic migraine with medication overuse headache were decreased. When comparing chronic migraine with medication overuse headache versus chronic migraine, connectivity between bilateral extended amygdala, and between paracingulate to right ventral tegmental area/substantia nigra were decreased in chronic migraine (chronic migraine < chronic migraine with medication overuse headache). Connectivity between left dorsolateral prefrontal cortex to bilateral ventral striatum/pallidum, to bilateral dorsal anterior cingulate cortex; left anterior prefrontal cortex to contralateral orbitofrontal insula; and left ventral striatum/pallidum to ipsilateral supplementary motor area (SMA)/preSMA were decreased in chronic migraine with medication overuse headache (chronic migraine with medication overuse headache < chronic migraine). Conclusion Both chronic migraine subgroups had shared intranetwork connectivity abnormality, however, each subgroup had unique pattern of disruption within the salience network. The results suggest that the aberrant assignment of salience to external and internal stimuli plays an important role in chronic migraine and chronic migraine with medication overuse headache interictally, mostly involving mesolimbic pathways (especially bilateral extended amygdala) in chronic migraine, and prefrontal-subcortical limbic pathways in chronic migraine with medication overuse headache.

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Christie, Suzanne N., Rose Giammarco, Marek Gawel, Gordon Mackie, Jonathan Gladstone, and Werner J. Becker. "Botulinum Toxin Type A and Acute Drug Costs in Migraine with Triptan Overuse." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 37, no. 5 (September 2010): 588–94. http://dx.doi.org/10.1017/s031716710001074x.

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Background:Patients with chronic migraine and medication overuse are significant consumers of health care resources.Objective:To determine whether botulinum toxin type A prophylaxis reduces the cost of acute migraine medications in patients with chronic migraine and triptan overuse.Methods:In this multicenter, open-label study, patients with chronic migraine (≥15 headache days/month) who were triptan overusers (triptan intake ≥10 days/month for ≥3 months) received botulinum toxin type A (95-130 U) at baseline and month three. Headache (HA) frequency and medication use were assessed with patient diaries, and headache-related disability by means of the MIDAS and Headache Impact Test-6 questionnaires.Results:Of 53 patients enrolled (mean age ± standard deviation, 46.5 years ± 8.4; 47 [88.7%] females), 48 (90.6%) completed the study at month six. Based on headache diaries, significant (P≤0.0002) decreases from baseline were observed for days per month with headache/migraine, days with any acute headache medication use, days with triptan use, and triptan doses taken per month. A significant (P<0.0001) increase from baseline in headache-free days per month was also observed. Prescription medication costs for acute headache medications decreased significantly, including significant reductions in triptan costs (mean reduction of -C$106.32 ± 122.87/month during botulinum toxin type A prophylaxis; P<0.0001). At baseline, 78% of patients had severe disability (MIDAS score) and 86.8% had severe impact due to headache (HIT-6 scores); at month six, this decreased to 60% and 68%, respectively.Conclusions:Botulinum toxin type A prophylactic therapy markedly decreased costs related to acute headache medication use in patients with chronic migraine and triptan overuse.

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Guy, Nathalie, Daniel Voisin, Aurélien Mulliez, Pierre Clavelou, and Radhouane Dallel. "Medication overuse reinstates conditioned pain modulation in women with migraine." Cephalalgia 38, no. 6 (August 20, 2017): 1148–58. http://dx.doi.org/10.1177/0333102417727545.

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Background This study investigated the effects of medication overuse and withdrawal on modulation of pain processing in women with migraine. Temporal summation of laser-evoked thermal pain was used to measure the effects of conditioned pain modulation. Methods 36 female participants (12 healthy volunteers, 12 with episodic migraine and 12 with medication overuse headache) were included in a two session protocol. Medication overuse headache subjects were also tested three weeks after medication overuse headache withdrawal. Mechanical and laser-evoked thermal pain thresholds were measured on the back of the non-dominant hand where, later, temporal summation of laser-evoked thermal pain to repetitive thermal stimuli was elicited for 30 min, at an intensity producing moderate pain. Between the 10th and 20th minutes, the contralateral foot was immersed into a water bath at a not painful (30℃) or painfully cold (8℃; conditioned pain modulation) temperature. Results Episodic migraine, medication overuse headache and medication overuse headache withdrawal were associated with an increase in extracephalic temporal summation of laser-evoked thermal pain as compared to healthy volunteer subjects, while there was no alteration of laser-evoked thermal and mechanical extracephalic pain thresholds in these subjects. Conditioned pain modulation was highly efficient in temporal summation of laser-evoked thermal pain in healthy volunteer subjects, with a solid post-effect (reduction of pain). Conditioned pain modulation was still present, but reduced, in episodic migraine. By contrast, conditioned pain modulation was normal in medication overuse headache and strongly reduced in medication overuse headache withdrawal. Furthermore, in medication overuse headache withdrawal, the post-effect was no longer a decrease, but a facilitation of pain. Conclusions These data show that a decrease in conditioned pain modulation does not underlie medication overuse headache in women. On the contrary, medication overuse reinstated conditioned pain modulation in female migraine patients. They also identify different phenotypes of pain modulation in migraine patients. Registration number N° 2008-A00471-54.

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