Overuse of symptomatic medications among chronic (transformed) migraine patients: profile of drug consumption

Krymchantowski, Abouch Valenty

doi:10.1590/s0004-282x2003000100007

Cited by 22 publications

(23 citation statements)

References 15 publications

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“…The combinations with caffeine were even more common than Dypirone, with 33% of patients taking one of the four combinations reported, but less frequent than common analgesic products (52.3%) ( Table 3). This finding is relevant since caffeine withdrawal has been associated with rebound headache 13 . Krymchantowsky has described that the combination of simple analgesics and caffeine was the most overused category of overused medications in a population of patients with transformed migraine, followed by simple analgesics 13 .…”

Section: Discussionmentioning

confidence: 88%

“…This finding is relevant since caffeine withdrawal has been associated with rebound headache 13 . Krymchantowsky has described that the combination of simple analgesics and caffeine was the most overused category of overused medications in a population of patients with transformed migraine, followed by simple analgesics 13 . Although we have not studied specific modalities of headache, it is possible that the pattern of self medication we have found is associated with a significant risk of transformed migraine in our region, specially considering that the type and amount of analgesic ingestion play a key role in the development of this condition.…”

Section: Discussionmentioning

confidence: 88%

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Headache epidemiology in Vitória, Espírito Santo

Domingues¹,

Kuster²,

Dutra³

et al. 2004

Arq. Neuro-Psiquiatr.

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-This is the first headache survey in the region of Vitória, ES Brazil. A high prevalence of headache sufferers was found (52.8%). Headache was more common among women (63.9%) and less common among people older than 55 years old. The type of professional activity was not related with the headache prevalence. The most frequent causal attribution was stress. Most headache sufferers are not under regular medical treatment (9%), and most of them use analgesic drugs without proper orientation. The most used compounds are combinations with caffeine (33%) and simple analgesics (52.3%).KEY WORDS: headache, prevalence, self medication. Epidemiologia da cefaléia em Vitória, Espírito SantoRESUMO -Este estudo é o primeiro a avaliar a prevalência da cefaléia na região de Vitória, ES. Demonstrouse alta prevalência de portadores de cefaléia (52,8%), com maior freqüência no sexo feminino (63,9%) e em pessoas com menos de 55 anos. Não houve diferença de prevalência em relação ao tipo de atividade profissional. O estresse foi apontado como o fator causal mais freqüente. Verificou-se que poucos portadores de cefaléia fazem acompanhamento médico regular (9%) e que a maioria usa medicamentos analgésicos sem orientação adequada, sendo os medicamentos mais utilizados combinações contendo cafeína (33%) e os analgésicos comuns (52,3%). PALAVRAS-CHAVE: cefaléia, prevalência, auto-medicação.The importance of primary headaches is related to the high frequency of headache disorders, considerable impact of headache on work and social activities, and to the consequences of a considerable consumption of drugs by headache sufferers Here we report the results of the first large epidemiological headache survey among inhabitants of the region of Great Vitória, Espírito Santo Brazil. This study aimed to identify the prevalence of headache symptoms, the causal attributions of headache, the medical assistance sought by the headache patients, and the pattern analgesic use reported by headache sufferers in this region of the country. METHODA questionnaire was administered by a group of medical students attending a specialized headache service. This questionnaire was randomly applied to Great Vitória region inhabitants, including the cities of Vitória, Vila Velha, Cariacica, and Serra. The interviewers have randomly selected people in public areas such as bus stations, schools, churches, supermarkets, banks, shopping centers, and sidewalks. Gender, age, and main occupation data were recorded. The individuals were grouped in three age groups: <30, 30-55, and >55 years. The occupation type was classified into the following categories: home, employed, liberal professional, unemployed, rested, or student. The prevalence of headache symptom was assessed asking if the individual consider him or herself as a headache sufferer. People answering no were not considered to have headache and no further questions were done. For the ones that considered him or herself as a headache sufferer the second question has evaluated the causal attributions of headach...

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 88%

Headache epidemiology in Vitória, Espírito Santo

Domingues¹,

Kuster²,

Dutra³

et al. 2004

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…several risk factors have been implicated in the transformation of episodic migraine to chronic migraine such as obesity, history of frequent attacks, excessive caffeine consumption, and overuse of symptomatic medication 3,4 . Medication overuse headache commonly develops in these patients 5,6 .…”

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confidence: 99%

Correlation between migraine subtipes and depression

Domingues

Costa

Silva

et al. 2008

Arq. Neuro-Psiquiatr.

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-This study has evaluated depression in patients with episodic migraine (n=98), chronic migraine without medication overuse (n=23), and chronic migraine with medication overuse (n=57). The Beck Depression Inventory (BDI) was used to evaluate depressive symptoms in these three groups. The mean BDI score obtained in all patients was higher than that observed in asymptomatic subjects (episodic migraine=16.09±11.79, chronic migraine with medication overuse=18.91±12.53, chronic migraine without medication overuse=19.83±14.79). This finding corroborates previous studies suggesting a co-morbid association between migraine and depression. Depression did not seem to be crucial in the transformation of migraine as the median BDI scores did not differ significantly between patients with episodic and chronic migraine. The median BDI scores of the patients with chronic migraine with medication overuse and that patients with chronic migraine without medication overuse were similar as well. Therefore, medication overuse behavior may not be related with depression.Key worDs: migraine, chronic migraine, analgesic abuse, depression. Correlação entre subtipos de migrânea e depressãoResumo -este estudo avaliou a depressão em pacientes com migrânea episódica (n=98), migrânea crônica com uso abusivo de analgésicos (n=57) e migrânea crônica sem uso abusivo de medicamentos analgésicos (n=23). o Inventário de Depressão de Beck (IDB) foi usado para avaliar sintomas depressivos nos três grupos. As médias dos escores de IDB encontradas (migrânea episódica=16.09±11.79, migrânea crônica com uso abusivo de analgésicos=18.91±12.53, migrânea crônica sem uso abusivo de analgésicos=19.83±14.79) foram maiores do que as observadas em indivíduos assintomáticos. Tais resultados confirmam estudos prévios indicando uma relação de comorbidade entre migrânea e depressão. os dados não sugerem que a depressão seja um fator determinante da transformação da migrânea episódica em migrânea crônica, pois nestes dois grupos as medianas dos escores de IDB foram semelhantes. os escores de IDB foram semelhantes entre os pacientes com migrânea crônica com e sem uso abusivo de analgésicos. Portanto, o comportamento de ingerir abusivamente analgésicos não parece estar relacionado com a depressão.PAlAvrAs-chAve: migrânea, migrânea crônica, abuso de analgésicos, depressão.1 headache clinic -escola superior de ciências da saúde de vitória, vitória es, Brazil (eMescAM);

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“…In fact, a majority of patients with a diagnosis of CM are in MO before the diagnosis of CM can be made. 110 Also it is challenging to control MO without patient participation, since many migraine medications are available without a prescription.…”

Section: Medication-overuse Headache (Moh)mentioning

confidence: 99%