Increased activity of serotonin uptake in platelets in medication overuse headache following regular intake of analgesics and triptans

Ayzenberg, Ilya; Oberman, Mark; Leineweber, Kirsten; Franke, L.; Yoon, Min‐Suk; Diener, Hans‐Christoph; Katsarava, Zaza

doi:10.1007/s10194-008-0019-9

Cited by 29 publications

(20 citation statements)

References 17 publications

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“…patientsNo. medication overuse headacheAnalgesicsErgotsOpioidsTriptansAltieri et al 2009 [11]ItalyICHD-2 [7]Clinic2711NRNR4Ayzenberg et al 2008 [12]GermanyICHD-2 [7]Clinic2914NRNR15Biagianti et al 2012 [13]ItalyICHD-2 Revised [8]Clinic5226NRNR20Boe et al 2007 [14]NorwayICHD-2 Appendix [7]Clinic100201NR23Coppola et al 2010 [15]ItalyICHD-2 Appendix [7]Clinic2910NRNR9Cupini et al 2009 [16]ItalyICHD-2 Appendix [7]Clinic33NR1NR4Di Lorenzo et al 2009 [17]ItalyICHD-2 [7]Clinic10718NRNR29Donnet et al 2009 [18]FranceICHD-2 [7]Population320157252964Dousset et al 2013 [19]FranceICHD-2 Appendix [7]Clinic428109Galli et al 2011 [20]ItalyICHD-2Appendix [7]Clinic82212322Gambini et al 2013 [21]ItalyICHD-2 Revised [8]Clinic6333NRNR21…”

Section: Methodsmentioning

confidence: 99%

Risk of medication overuse headache across classes of treatments for acute migraine

et al. 2016

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BackgroundThe most commonly prescribed medications used to treat migraine acutely are single analgesics, ergots, opioids, and triptans. Due to varying mechanisms of action across drug classes, there is reason to believe that some classes may be less likely than others to elicit Medication Overuse Headache (MOH) than others. We therefore aimed to determine whether certain classes of acute migraine drugs are more likely to elicit MOH than others.MethodsA comprehensive systematic literature was conducted to identify studies of varying designs that reported on MOH within the considered treatment classes. Only studies that reported MOH according to the International Classification of Headache Disorders (ICHD) were considered. Since no causal comparative design studies were identified; data from prevalence studies and surveys were retrieved. Prevalence-based relative risks between treatment classes were calculated by integrating both medication overuse and medication use from published studies. For each pair wise comparison, pooled relative risks were calculated as the inverse variance weighted average.ResultsA total of 29 studies informed the relative risk between treatment classes, all of which reported country-specific data. Five studies reported country-specific medication use data. For triptans versus analgesics the study relative risks generally favored triptans. The pooled relative risk was 0.65 (i.e., relative risk reduction of 35 %). For ergots versus analgesics, a similar trend was observed in favor of ergots with a relative risk of 0.41. For triptans versus ergots, the direction of effect was mixed, and the pooled relative risk was 1.07. Both triptans and ergots appeared favorable when compared to opioids, with pooled relative risks of 0.35 and 0.76, respectively. However, the evidence was limited for these comparisons. Analgesics and opioids also appeared to yield similar risk of MOH (pooled relative risk 1.09).ConclusionOur study suggests that in patients receiving acute migraine treatment, analgesics and opioids are associated with a higher risk of developing MOH compared with other treatments. These findings provide incentive for better monitoring of use of analgesics and opioids for treating acute migraine, and suggest possible clinical preference for use of so-called “migraine-specific” treatments, that is, triptans and ergots.Electronic supplementary materialThe online version of this article (doi:10.1186/s10194-016-0696-8) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Risk of medication overuse headache across classes of treatments for acute migraine

et al. 2016

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“…This receptor upregulation was normalized after drug withdrawal . Activity of the platelet serotonin transporter was increased in patients with analgesic‐ and triptan‐induced MOH . These findings suggest a suppression of 5‐HT function in MOH.…”

Section: Pathophysiological Changes In Moh—clinical Evidencementioning

confidence: 83%

Pathophysiology of Medication Overuse Headache—An Update

et al. 2013

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The pathogenesis of medication overuse headache is unclear. Clinical and preclinical studies have consistently demonstrated increased excitability of neurons in the cerebral cortex and trigeminal system after medication overuse. Cortical hyperexcitability may facilitate the development of cortical spreading depression, while increased excitability of trigeminal neurons may facilitate the process of peripheral and central sensitization. These changes may be secondary to the derangement of central, probably serotonin (5-HT)-, and perhaps endocannabinoid-dependent or other, modulating systems. Increased expression of excitatory cortical 5-HT2A receptors may increase the susceptibility to developing cortical spreading depression, an analog of migraine aura. A reduction of diffuse noxious inhibitory controls may facilitate the process of central sensitization, activate the nociceptive facilitating system, or promote similar molecular mechanisms to those involved in kindling. Low 5-HT levels also increase the expression and release of calcitonin gene-related peptide from the trigeminal ganglion and sensitize trigeminal nociceptors. Thus, derangement of central modulation of the trigeminal system as a result of chronic medication use may increase sensitivity to pain perception and foster or reinforce medication overuse headache. Keywords: medication overuse headache, serotonin, trigeminal system, sensitization, endogenous pain control system, diffuse noxious inhibitory controlOveruse of symptomatic medications is a common problem observed in patients with primary headaches, especially migraine and tension-type headache. In addition to other adverse effects, prolonged use of these abortive compounds can produce the paradoxical effect of deteriorating the underlying headache pathophysiology. This results in a clinical syndrome known as "medication overuse headache" (MOH). According to the International Classification of Headache Disorders (2nd edition), MOH refers to the frequent headache condition (15 days per month or more) that occurs in patients with primary headaches who regularly use 1 or more acute and/or symptomatic drugs for more than 3 months.1 This clinical syndrome is common. Population-based studies report the 1-year prevalence rate of MOH to be from 1% to 2%.2 The relative frequency is much higher in secondary and tertiary care centers.3 This disorder strongly affects the quality of life of patients and causes substantial economic burden.There is no clear explanation of how chronic abortive drug exposure can increase headache frequency and result in MOH. Some possible mechanisms have been summarized in recent reviews. [4][5][6] In this article, we review the recent studies, both clinical and preclinical, investigating the pathogenesis of this condition. Possible mechanisms underlying the process of medication-induced headache transformation are also proposed. SOME CLINICAL CLUESSome clinical features of MOH provide clues about its pathogenesis. First, MOH occurs mostly in patients with primary headaches. Ch...

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“…One of the underlying mechanisms could involve an alteration in the turnover of serotonin (5HT). This is supported by the observation that patients with analgesic‐ or triptan‐induced MOH, in comparison with patients with episodic migraine and controls, display a higher 5HT uptake rate in platelets which is restored after withdrawal in parallel to the improvement of headache frequency [3]. This is of particular interest in view of the fact that 5HT plays an important role not only in migraine and headache but also in the sensitization caused by drugs and in the development of drug dependence [4,5].…”

Section: Introductionmentioning

confidence: 78%

Association of haplotype combination of serotonin transporter gene polymorphisms with monthly headache days in MOH patients

Terrazzino

Tassorelli

Sances

et al. 2011

Euro J of Neurology

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Increased activity of serotonin uptake in platelets in medication overuse headache following regular intake of analgesics and triptans

Cited by 29 publications

References 17 publications

Risk of medication overuse headache across classes of treatments for acute migraine

Risk of medication overuse headache across classes of treatments for acute migraine

Pathophysiology of Medication Overuse Headache—An Update

Association of haplotype combination of serotonin transporter gene polymorphisms with monthly headache days in MOH patients

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