Analgesic Overuse <i>Is</i> A Cause of Chronic Daily Headache

Tepper, Stewart J.

doi:10.1046/j.1526-4610.2002.02133_1.x

Cited by 51 publications

(16 citation statements)

References 20 publications

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“…Analgesic overuse might be a significant predictor of persistent chronic daily headache. A plausible explanation of this phenomenon could be that overuse of analgesics may induce alterations in nociceptive neural networks, which also would apply for those with chronic headache [14,15]. In conclusion, these data could confirm the findings of other population groups that morbidity from headache is often unrecognised and undertreated.…”

Section: Discussionsupporting

confidence: 72%

A questionnaire–based study on prevalence and treatment of headache in young children

et al. 2005

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IntroductionHeadache is a common symptom in hospital practice. Causes include migraine and tension headache as well as headache secondary to intracranial and extracranial infections, intracranial mass lesions, and head or neck trauma [1]. Headache occurs in a large proportion of young students and prevalence increases with age [2][3][4]. In addition, by the age of 5, 25% of children have had a notable headache, a proportion that increases to 75% by the age of 15 [5,6].The lifetime prevalence of headache increases from 47.2% in 7-9-year-old children to 69.5% in 13-15-yearold children [3,4,7].There are not many reports on the effects of individual and social factors on the incidence of headache in young people. Therefore, in this study we evaluated the incidence of headache in young people, examined associated factors and described the drug therapy used. MethodsThe target population consisted of all 14-18-year-old students in the city of Catanzaro, Italy.This study was conducted in two phases. A questionnaire-based study on prevalence and treatment of headache in young children Abstract Headache occurs in a large proportion of young students. In this study we evaluated the incidence of headache in young people, examined associated factors and described the drug therapy used. A structured questionnaire was directly administered to 2700 students of secondary schools of Catanzaro. We recorded that headache symptoms started between 9 and 12 years of age. The incidence density was higher in people living in the city (84%) and in tobacco and alcohol users than non-users (p<0.01). The most common drugs used were non-steroidal anti-inflammatory drugs. In 20% of people, this treatment induced the development of chronic headache. These data showed that morbidity from headache is often unrecognised and undertreated. Better management of headache symptoms and therapy could reduce the frequency of headache episodes, with a reduction of adverse drug reactions.

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Section: Discussionsupporting

confidence: 72%

A questionnaire–based study on prevalence and treatment of headache in young children

et al. 2005

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“…However, it is still a matter of debate whether the overuse is a consequence of living with chronic headache or the other way round [Dodick, 2002;Tepper, 2002]. Furthermore, not all headache patients with medication overuse develop MOH, and the mechanism how chronic exposure to abortive medication leads to MOH remains unclear.…”

Section: Pathogenesismentioning

confidence: 99%

Medication-overuse headache: epidemiology, diagnosis and treatment

Kristoffersen

Lundqvist

2014

Therapeutic Advances in Drug Safety

137

100

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Medication-overuse headache (MOH) is one of the most common chronic headache disorders and a public health problem with a worldwide prevalence of 1-2%. It is a condition characterized by chronic headache and overuse of different headache medications, and withdrawal of the overused medication is recognised as the treatment of choice. However, the strategy for achieving withdrawal is, at present, based on expert opinion rather than scientific evidence, partly due to the lack of randomised controlled studies. This narrative review investigates different aspects of epidemiology, diagnosis, risk factors and pathogenesis as well as management for MOH. We suggest that the first step in the treatment of MOH should be carried out in general practice and should focus primarily on detoxification. For most patients, both prevention and follow up after detoxification can also be performed in general practice, thus freeing resources for referral of more complicated cases to headache clinics and neurologists. These suffering patients have much to gain by an earlier treatment-focused approach lower down on the treatment ladder.

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“…Improvement in two thirds to three quarters of patients after successful medication withdrawal supports its causative role in generating or maintaining chronic headache. However, it is still a matter of debate whether the overuse is a consequence or cause of chronic headache 81,82. Further, not all headache patients with medication-overuse develop MOH, and the mechanism behind how chronic exposure to abortive medication leads to MOH remains unclear.…”

Section: Pathogenesismentioning

confidence: 99%

Medication-overuse headache: a review

Kristoffersen

Lundqvist²

2014

JPR

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Medication-overuse headache (MOH) is a worldwide health problem with a prevalence of 1%–2%. It is a severe form of headache where the patients often have a long history of headache and of unsuccessful treatments. MOH is characterized by chronic headache and overuse of different headache medications. Through the years, withdrawal of the overused medication has been recognized as the treatment of choice. However, currently, there is no clear consensus regarding the optimal strategy for management of MOH. Treatment approaches are based on expert opinion rather than scientific evidence. This review focuses on aspects of epidemiology, diagnosis, pathogenesis, prevention, and treatment of MOH. We suggest that information and education about the risk of MOH is important since the condition is preventable. Most patients experience reduction of headache days and intensity after successful treatment. The first step in the treatment of MOH should be carried out in primary care and focus primarily on withdrawal, leaving prophylactic medication to those who do not manage primary detoxification. For most patients, a general practitioner can perform the follow-up after detoxification. More complicated cases should be referred to neurologists and headache clinics. Patients suffering with MOH have much to gain by an earlier treatment-focused approach, since the condition is both preventable and treatable.

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Analgesic Overuse Is A Cause of Chronic Daily Headache

Cited by 51 publications

References 20 publications

A questionnaire–based study on prevalence and treatment of headache in young children

A questionnaire–based study on prevalence and treatment of headache in young children

Medication-overuse headache: epidemiology, diagnosis and treatment

Medication-overuse headache: a review

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