Dependent Behavior in Patients with Medication-Overuse Headache

Fuh, Jong Ling; Wang, Shuu Jiun

doi:10.1007/s11916-011-0240-0

Cited by 29 publications

(27 citation statements)

References 48 publications

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“…Therefore, in our study, patients with unsuccessful outcome (NR-group) had, in some items, a LDQ subscore similar to that found in addicts in items assessing compulsive dependence according to DSM-IV criteria [18, 25, 29]. …”

Section: Discussionmentioning

confidence: 68%

Drug-dependence behaviour and outcome of medication-overuse headache after treatment

2012

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This study aimed at determining the causes of failure of the different proposed strategies to ensure improvement of medication-overuse headache (MOH) patients, since they have not been investigated so far, especially with regard to aspects related to cognitive and behavioural aspects of symptomatic drugs overused by them. One hundred and twenty in-patients, 82 females (68.3 %), median age 49 (42–56) years, affected by MOH were admitted to the study and treated with abrupt discontinuation of the medication overused, a 6-day in-patient detoxification regimen and an immediate start of personalized prophylactic treatment, then followed for 1 year. Leeds Dependence Questionnaire (LDQ), among all the clinical variables, was administered at baseline and at 1-year follow-up visit to assess substance dependence. Of the 120 patients enrolled, 68 (56.7 %) were successfully detoxified (Responder-group), while 52 (43.3 %) were not (Non-Responder-group). At baseline, the mean LDQ total score was slightly higher in the Non-Responder group than in the Responder group (12.08 ± 2.14 vs. 11.94 ± 1.98). Although this difference was not significant at baseline (p > 0.05), the LDQ total score was significantly different (p < 0.001) at the 1-year follow-up visit between the responder group (7.8 ± 2.3) and the Non-Responder group (12.1 ± 2.1). Moreover, the pattern of the responses of the patients in the responder group differed from that of the Non-Responder-group in the items relating to the compulsion to start, compulsion to continue, primacy of effect, constancy of state and cognitive set. The results showed that patients of the Non-Responder group showed a drug dependence pattern similar to that previously described in addicts. Conversely, in patients who positively responded to the procedure, drug-abuse behaviour seemed to be a consequence of chronic headache, reflecting the need for daily analgesic use to cope with everyday life.

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Section: Discussionmentioning

confidence: 68%

Drug-dependence behaviour and outcome of medication-overuse headache after treatment

2012

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“…Studies suggest that MOH represents a spectrum of addictive behaviors and some have shown a relation to characteristics of obsessive‐compulsive personality disorder . If MOH exemplifies a dependency‐like behavior, personality traits should differ as compared to migraine patients.…”

Section: Introductionmentioning

confidence: 99%

Personality traits in migraine and medication‐overuse headache: A comparative study

et al. 2019

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Medication-overuse headache (MOH) is a disorder where frequent use of pain medication leads to an unhealthy circular process of persistent headache and increased medication intake. 1 This results in severe disability affecting all aspects of life. 2 MOH is considered a biobehavioral disorder, with both biological and psychological factors contributing to the onset. Hence, targeting both factors in treatment Objectives: Medication-overuse headache (MOH) is recognized as a biobehavioural disorder, warranting that both biological and psychological factors are targeted throughout treatment. A psychological factor of importance may be personality that could be used to tailor treatment if differences are found across headache diagnoses. The objectives were as follows: (a) To investigate if migraine patients and patients with MOH differed on personality traits, (b) To investigate if the two headache groups differed from a Danish normative sample, with respect to personality traits. Materials and Methods: The NEO-Five-Factor Inventory was completed, and an agematched cohort of episodic migraine patients (n = 94) and MOH patients (n = 94) was included. Multivariate regression models and sex-stratified comparisons were made on patients' raw scores from five personality traits; neuroticism, extraversion, openness, agreeableness, and conscientiousness. The headache groups were also compared to personality traits from a Danish normative sample (n = 1032).Results: MOH females obtained significantly lower scores on extraversion (24.4 ± 4.3 vs 27.1 ± 7.2, P < 0.01), openness (23.7 ± 3.9 vs 26.2 ± 6.4, P < 0.01), and conscientiousness (28.9 ± 3.7 vs 34.6 ± 5.8, P > 0.01) as compared to female migraineurs.Males showed no differences. Compared to the normative sample, both headache groups showed a lower score on extraversion (P < 0.01). Furthermore, MOH patients had statistically significant lower scores on conscientiousness while the migraine patients had a higher score. Conclusion:Results suggests some personality trait differences between migraine and MOH patients. Especially, females showed different personality traits, where the MOH females appeared more introvert and less socially orientated. If confirmed in larger studies, this information could be used in personalized treatment in clinical practice.

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“…Medication abuse by headache patients may share pathogenic mechanisms and genetic factors with other types of drug through enhancement of predisposition factors [150][151][152]. In this sense, inhibition of histone deacetylase 3 seems to play a role in the memory processes involved in cessation of drug dependency in animal models [153].…”

Section: Medication Abusementioning

confidence: 99%

Current Evidence on the Role of Epigenetic Mechanisms in Migraine: The Way Forward to Precision Medicine

Gazerani¹

2018

obm genet

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Interactions between genetic and environmental factors in migraine are well known and can potentially determine an individual's susceptibility to disease and responsiveness to treatment. Consequently, several epigenetic studies have been conducted to determine if and how genes are activated or inactivated in response to a diverse range of environmental migraine triggers. The results, in turn, have helped elucidate how these factors can promote or inhibit migraine progression or therapeutic response and can guide development of precision medicines for migraine treatment. This review summarizes the current evidence and latest findings (accessible mainly through Medline-PubMed) that reveal epigenetic processes contributing to migraine pathogenesis acting via various distinct mechanisms. One of the most studied mechanisms, DNA methylation within the human methylome, may provide a potential epigenetic signature for migraine. Recent basic experimental data and clinical findings will be presented here to highlight that epigenetic studies hold great potential to explain risk factors, migraine chronification, and therapeutic responses. Current challenges and unmet needs are also addressed to promote further investigation of the role of migraine epigenetics in disease pathophysiology and to discover useful biomarkers to guide development of more effective therapeutics.

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Dependent Behavior in Patients with Medication-Overuse Headache

Cited by 29 publications

References 48 publications

Drug-dependence behaviour and outcome of medication-overuse headache after treatment

Drug-dependence behaviour and outcome of medication-overuse headache after treatment

Personality traits in migraine and medication‐overuse headache: A comparative study

Current Evidence on the Role of Epigenetic Mechanisms in Migraine: The Way Forward to Precision Medicine

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