Headache after frequent use of serotonin agonists zolmitriptan and naratriptan

Limmroth, Volker; Kazarawa, Zaza; Fritsche, Günther; Diener, Hans‐Christoph

doi:10.1016/s0140-6736(05)74950-3

Cited by 133 publications

(58 citation statements)

References 4 publications

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“…22 Another problem is the actual overuse of such medications which causes 'medication overuse headache' (MOH), further complicating management strategies. 23 A large percentage of patients do not respond to pharmacological interventions for migraine headache, develop unacceptable side-effects, or are reluctant to take medications. 24 As a result many patients resort to many complementary and alternative therapies like acupuncture, biofeedback therapy, relaxation therapy, herbal remedies and vitamin or mineral supplementation.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of panchgavya GHRIT along with flunarizine in prophylaxis for migraine patients: a comparitive study

Trivedi

Dixit

Mahmood

et al. 2017

Int J Basic Clin Pharmacol

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Background: Propranolol and flunarizine have proven to be useful tools in migraine prophylaxis. This trial aims the comparison of the efficacy of flunarizine, flunarizine and placebo and flunarizine and panchgavya ghrit in migraine prophylaxis.Methods: The present study was a prospective, randomized, open-label, blinded-endpoint trial. Patients with chronic migraine were randomized (1:1:1) to flunarizine and flunarizine and placebo and flunarizine and panchgavya ghrit in three treatment groups. The study was carried out in outdoor patients in the department of Psychiatry, T.S. Mishra Medical College and Hospital, Lucknow and K.G.M.U, Ayush Department, Lucknow after clearance from Institutional Ethical Committee. Data was analysed using SPSS software.Results: The prevalence of migraine was found to be higher in the age group greater than 30 years and females. Overall there was more reduction in CGI scores in flunarizine with panchgavya ghrit and the other two groups equally at the end of 4, 6 8 and 10 weeks. Decrease in MIDAS score was observed after the therapy. Clinical Global Impression rating scale employed revealed that to start with subjects scored 7 which stands for pathology interfering in many life functions which reduced drastically in Group C as compared to Group B and Group A in descending order. Pain scales namely VAS (visual analogue scale), NPRS (Numeric Pain Rating Scale), VRS (verbal rating scale) when employed denoted there was decreased migraine frequency, decreased perception of pain, less intake of abortive medication consumed by subjects implying there were reduction in number of migraine days and there was decrease in the abortive medications taken for the same. Group C scored better on pain scales followed by Group B and Group A. Lower proportion of individuals in group C had Behavioural Toxicity and Neurological Side effects as compared to Group A and B.Conclusions: Panch gavya ghrit when administered along with flunarizine was more efficacious and safe when compared with other two groups. However large multicentric RCTs of long duration and involving more number of subjects are required to ascertain these facts.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of panchgavya GHRIT along with flunarizine in prophylaxis for migraine patients: a comparitive study

Trivedi

Dixit

Mahmood

et al. 2017

Int J Basic Clin Pharmacol

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“…En los años 90 se publican los primeros trabajos que implican a los triptanes en el mantenimiento y/o agravamiento de la cefalea preexistente 8,9 .…”

Section: Cefalea Crónica Y Abuso De Analgésicosunclassified

Cefalea crónica diaria con Abuso de Analgésicos

Garmilla¹,

Gómez

Chacartegui³

2009

Rev Clin Med Fam

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RESUMENLa cefalea crónica diaria es una entidad frecuente en la población general. Un alto porcentaje de pacientes con cefalea crónica diaria tiene un consumo abusivo de analgésicos que hace que la cefalea empeore y además puede tener riesgo de múltiples patologías producidas por estos fármacos. El médico de familia ocupa una posición privilegiada para la detección e intervención de esta patología, consiguiendo con ello una mejoría de la cefalea, un aumento de la calidad de vida del paciente y una disminución del gasto sanitario. Palabras clave: Cefaleas Secundarias. Analgésicos. ABSTRACTChronic daily headache with analgesic abuse Chronic daily headache is common in the general population. A high percentage of patients with chronic daily headache overuse analgesics. This contributes to a worsening of the headache and increases the risk of other conditions secondary to analgesic overuse. The family doctor is in a good position to detect and rectify this abuse, resulting in headache relief, increased quality of life and a reduced pharmaceutical cost. Key words. Headache Disorders, Secondary, Analgesics. EPIDEMIOLOGÍALa cefalea crónica diaria (CCD) es frecuente en la práctica clínica diaria. Dado que la mayoría de los enfermos que consultan por este motivo abusan de analgésicos, este factor se ha puesto directamente en relación con la cronificación de la cefalea primaria de base. España ha sido pionera en el estudio de la epidemiología de la CCD. En población general se estima una prevalencia de CCD del 4,7% 1 y una prevalencia del 1,5% de pacientes con cefalea crónica y abuso de analgésicos (CAA) 2 , por tanto aproximadamente un tercio de los pacientes con CCD cumplen criterios de abuso de analgésicos. En Unidades de cefalea aproximadamente el 40% de los pacientes tienen CAA 3 , lo que confirma la elevada prevalencia del abuso de analgésicos por cefalea. CEFALEA CRÓNICA Y ABUSO DE ANALGÉSICOSEn los años 50 se realizan las primeras descripciones de pacientes cuyas cefaleas empeoraron al consumir diariamente ergotamina 4 y posteriormente aparecen nuevos estudios que implican analgésicos simples y opioides en la cronificación de la cefalea, dando lugar al concepto de cefalea por abuso de analgésicos o cefalea de rebote 5,6,7 . En los años 90 se publican los primeros trabajos que implican a los triptanes en el mantenimiento y/o agravamiento de la cefalea preexistente 8,9 .Otros autores han tratado de investigar si el consumo de analgésicos por sí mismo puede producir cefalea crónica en pacientes sin antecedentes de cefalea primaria. Se han realizado estudios en grupos de pacientes que tomaban analgésicos diariamente por dolor músculo-esquelético o procesos reumatológicos, no encontrando mayor prevalencia de cefalea crónica que en la población general 10,11 .

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“…MOH has been associated with the use of opioids, ergot derivatives, and triptans [2][3][4]. Case reports pertaining to MOH were published shortly after the launch of sumatriptan [9,16], naratriptan, eletriptan, and zolmitriptan [10,17]. MOH may share characteristics with drug dependence [9]; the latter is defined [18] as a maladaptive pattern of substance use, leading to clinically significant impairment or distress manifested by one or more of seven criteria ( Table 1).…”

Section: Introductionmentioning

confidence: 99%

Drug dependence associated with triptans and ergot derivatives: a case/non-case study

Beau-Salinas

Jonville-Béra

Cissoko

et al. 2009

Eur J Clin Pharmacol

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Introduction The aim of this case/non-case study was to assess and compare the risk of drug dependence associated with different migraine-specific drugs, i.e., ergot derivatives and triptans, using the French pharmacovigilance database. Methods Reports on drug side effects recorded in this database between January 1985 and June 2007 were analyzed, and triptans (almotriptan, eletriptan, naratriptan, sumatriptan, and zolmitriptan) as well as ergot derivatives used in acute migraine were examined. For all reports, cases were defined as those reports corresponding to "drug abuse," "physical or mental drug dependence," and "pharmacodependence," whereas "non-cases" were defined as all the remaining SED reports. The method's reliability was assessed by calculating the risk associated with a negative (amoxicillin) and a positive (benzodiazepines) control. The risk of dependence associated with each drug and control was evaluated by calculating the odds ratio (OR) with a confidence interval of 95%. Results Among the 309,178 reports recorded in the database, drug dependence accounted for 0.8% (2,489) of the reports, with 10.9% (449) involving a triptan, and 9.33% (332) an ergot derivative. The risk of dependence was similar for triptans and ergot derivatives and did not differ from that of benzodiazepines. In the triptan group, the risk (odds ratio [95% CI]) ranged from 10. 3 [4.8-22.3] for sumatriptan to 21.5 for eletriptan [10.1-45.6], while in the ergot derivative group, it ranged from 12 [8-17.9] for ergotamine to 20.6 [8-53] for dihydroergotamine. Conclusions These findings confirm the hypothesis that triptans and ergot derivatives are associated with an increased risk of drug dependence.

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Headache after frequent use of serotonin agonists zolmitriptan and naratriptan

Cited by 133 publications

References 4 publications

Efficacy and safety of panchgavya GHRIT along with flunarizine in prophylaxis for migraine patients: a comparitive study

Efficacy and safety of panchgavya GHRIT along with flunarizine in prophylaxis for migraine patients: a comparitive study

Cefalea crónica diaria con Abuso de Analgésicos

Drug dependence associated with triptans and ergot derivatives: a case/non-case study

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