Medication-overuse headache in patients with cluster headache

Paemeleire, Koen; Bahra, Anish; Evers, Stefan; Matharu, Manjit; Goadsby, Peter J.

doi:10.1212/01.wnl.0000223332.35936.6e

Cited by 151 publications

(85 citation statements)

References 66 publications

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“…A recent, population-based study [34] found that the use of barbiturates or opiates led to an increased risk of developing transformed migraine. Such data were consistent with earlier clinicbased studies in which migraine patients treated with opioids for other biological or pain issues were likely to develop transformed migraine [35][36][37]. Hence, extreme caution should be the rule in the use of opioids or butalbital agents in migraine patients (even for other medical issues).…”

Section: Behavioral Assessmentsupporting

confidence: 88%

Application of behavioral therapies in adult and adolescent patients with chronic migraine

Weeks

2013

Neurol Sci

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Patients with chronic migraine (CM) headaches present some of the most difficult treatment challenges for headache practitioners. Attention to psychological and behavioral issues become significant treatment considerations as the frequency of a patient's headaches increases, there is increased disability secondary to headaches, and/or there is inadequate response to usually effective treatment. Recent research has identified a variety of risk factors (including medication overuse) that appear to be associated with the escalation of the frequency and severity of migraine headache and are amenable to behavioral (nonpharmacological) treatment. The present article will highlight therapies that may be effective in the treatment of patients with CM headache.

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Section: Behavioral Assessmentsupporting

confidence: 88%

Application of behavioral therapies in adult and adolescent patients with chronic migraine

Weeks

2013

Neurol Sci

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“…Ez különösen abban az esetben jelentős, ha migrénben vagy tenziós fejfájásban szenvedő betegek szednek rendszeresen, nagy adagban fájdalomcsillapító-kat [10], még akkor is, ha más betegség miatt szedik ezeket a gyógyszereket [26]. Jóval ritkábban, de előfordul FTTF olyan betegek körében is, akik korábban nem voltak fejfájósok, de családjukban többeknek volt migrénje [27]. Nem elhanyagolható a pszichológiai kockázati té-nyezők szerepe sem: az anticipátoros szorongás, illetve a hangulatzavar is hozzájárulnak a gyógyszerek túlzott mértékű fogyasztásának kialakulásához, illetve annak fenntartásához.…”

Section: Kockázati Tényezőkunclassified

Fájdalomcsillapító-túlhasználathoz társuló fejfájás

et al. 2015

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A fájdalomcsillapító-túlhasználathoz társuló fejfájás a lakosság 1-2%-át érinti. Bármely fájdalomcsillapító rendszeres, havonta legalább 10 napon történő szedése kiválthatja, ezért minden olyan esetben gondolni kell rá, amikor koráb-ban is panaszos betegek fejfájásának gyakorisága -nagyobb mennyiségben szedett fájdalomcsillapítók mellett -megnő. A kórkép leggyakrabban a 40-50 éves nőket érinti: kockázatát növeli a dohányzás, az elhízás, a depresszió, valamint a szorongásos zavar. Kialakulásában biológiai (genetikai megalapozottság, neurokémiai és neurofi ziológiai eltérések) mellett pszichológiai, illetve életvezetési tényezők, így a fejfájásokra vonatkozó anticipátoros szorongás, a fájdalom katasztrofi zálása, az ezek miatti kényszeres gyógyszerszedő magatartás is fontos szerepet játszanak. A fáj-dalomcsillapító-túlhasználathoz társuló fejfájás kezelésének elengedhetetlen része a kiváltó szer megvonása, a megvonási tünetek (köztük a rebound fejfájás) kezelése, a hatásos preventív terápia bevezetése, a komorbid betegségek kezelése, valamint a betegek megfelelő oktatása és pszichés támogatása. Mivel a visszaesés esélye megfelelő kezelés mellett is 30-40% lehet, alapvető fontosságú a megelőzés, amelyben az alapellátás szerepét nem lehet eléggé hangsúlyozni. Orv. Hetil., 2015, 156(30), 1195-1202. Kulcsszavak: fejfájás, fájdalomcsillapító-túlhasználat Medication-overuse headacheMedication-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 signifi cant 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.

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“…14,120 Within this group of MOH patients, the vast majority first present with episodic migraine or tension-type headache 121 as opposed to other forms of primary headache such as cluster headache. 122 We hypothesise this selective propensity to develop MOH stems from altered pro-inflammatory central immune signalling in patients with migraine and tension-type headache, or the presence of underlying central sensitisation, which renders them particularly susceptible to the effects of opioid-induced glial activation.…”

Section: Pro-inflammatory Central Immune Signalling Hypothesis Of Mohmentioning

confidence: 99%

Medication-overuse headache and opioid-induced hyperalgesia: A review of mechanisms, a neuroimmune hypothesis and a novel approach to treatment

et al. 2012

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What happens if you have no funding?Authors can make their articles Open Access by archiving their article at no charge (the Green route). Authors can do this by depositing the version of the article accepted for publication (version 2) in their own institution's repository. As a SAGE author, your rights in relation to your article if it is not published with payment of an APC are: You retain copyright in your work. You may do whatever you wish with the version of the article you submitted to the journal -version 1. Once the article has been accepted for publication, you may post the accepted version (version 2) of the article on your own personal website, your department's website or the repository of your institution without any restrictions.

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Medication-overuse headache in patients with cluster headache

Abstract: Medication-overuse headache is a previously underrecognized and treatable problem associated with cluster headache (CH). CH patients should be carefully monitored, especially those with a personal or family history of migraine.

Cited by 151 publications

References 66 publications

Application of behavioral therapies in adult and adolescent patients with chronic migraine

Application of behavioral therapies in adult and adolescent patients with chronic migraine

Fájdalomcsillapító-túlhasználathoz társuló fejfájás

Medication-overuse headache and opioid-induced hyperalgesia: A review of mechanisms, a neuroimmune hypothesis and a novel approach to treatment

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