Self-help group and medication overuse headache: preliminary data

Sancisi, Elisa; Rausa, Marialuisa; Zanigni, Stefano; Cevoli, Æ Sabina; Pala, Andrea Norcini; Nicodemo, Marianna; Grimaldi, Daniela; Montagna, Pasquale; Cortelli, Pietro; Pierangeli, Giulia

doi:10.1007/s10072-009-0131-x

Cited by 5 publications

(7 citation statements)

References 27 publications

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“…This latter study is the only one that included a no-treatment control group. Four other studies that focused on other interventions are summarized in the following paragraph (49)(50)(51)(52).…”

Section: Resultsmentioning

confidence: 99%

“…We found 27 studies (45 articles) reporting the treatment response to early discontinuation therapy (9,12,14,24,25,29–69). Among them, 19 studies (37 articles) reported the results of Early discontinuation with preventive medication (9,12,24,25,29–45, 53…”

Section: Resultsmentioning

confidence: 99%

“…Studies also reported other treatment methods to be effective and beneficial in early discontinuation and treating MOH patients, including a “brief intervention” scheme (49), self-help group (50) or a multidisciplinary treatment program including behavioral plus pharmacological treatment (51), and short-term psychodynamic psychotherapy (STPP) (52).…”

Section: Resultsmentioning

confidence: 99%

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Treatment of medication-overuse headache: A systematic review

et al. 2015

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Considering current available evidence and the systemic toxicity of overusing acute headache medication, we suggest discontinuation of the overused medication with the addition of preventive medication. Appropriately sized, randomized controlled trials evaluating the safety and long-term efficacy of preventive medication plus early discontinuation of overuse vs preventive medication alone vs early discontinuation of overuse alone are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Treatment of medication-overuse headache: A systematic review

et al. 2015

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“…Nowadays there are several therapeutic approaches to CM associated to MO regarding the (1) type of withdrawal (gradual vs. abrupt), (2) management of the patient (outpatient vs. inpatient), (3) use of preventive treatment (immediate vs. delayed) and (4) presence or absence of a non-pharmacological concomitant treatment (group therapies, behavioral therapy and psychotherapy) ( 11 , 12 ). Current guidelines for the treatment of CM include the use of onabotulinumtoxinA.…”

Section: Introductionmentioning

confidence: 99%

OnabotulinumtoxinA: An Effective Tool in the Therapeutic Arsenal for Chronic Migraine With Medication Overuse

et al. 2018

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Objective: To evaluate the early response of onabotulinumtoxinA as a treatment tool in patients with chronic migraine (CM) and medication overuse (MO).Patients and Methods: This is a retrospective study in patients with CM and MO who received two cycles of onabotulinumtoxinA infiltrations following PREEMPT protocol. We evaluated the efficacy of onabotulinumtoxinA in MO resolution, defined as less than 10 days/month of acute medication intake (triptans, opioids, and combinations) or 15 days/month (non-steroidal anti-inflammatory drugs - and simple analgesics). In addition, we analyzed changes in headache frequency, pain intensity, and headache-related disability (MIDAS scale). A multivariate analysis was carried out to identify factors independently related to MO resolution.Results: We included 139 consecutive patients with CM and MO. After 2 cycles of onabotulinumtoxinA, 73.4% had ≥50% reduction in acute medication intake and 57.6% achieved MO resolution. 7.9% of patients did not use any acute medication after treatment. Even though both MO-ongoing group and MO-resolution group improve in headache frequency, the reduction was significantly higher for the group which discontinued the use of acute medication after onabotulinumtoxinA treatment (p < 0.001). In this group, 73.0% reduced headache frequency ≥50%. Daily headache changed from 71.2 to 23.2% (p < 0.001). Both groups showed an improvement in pain intensity and in MIDAS score (p < 0.05). In the multivariate analysis we observed that MO resolution had an inverse association with medication intake at baseline (OR:0.294, p < 0.05) and a direct association with frequency (OR:20.455, p < 0.001) and MIDAS score (OR: 6.465, p < 0.05) improvements.Conclusion: OnabotulinumtoxinA has an early beneficial effect on the discontinuation of acute medication in a substantial proportion of patients with CM and MO. Therefore, onabotulinumtoxinA might be considered a therapeutic tool in CM with MO.

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“…Despite the limits of this study, our results suggest that cephalalgiaphobia should be better investigated by clinicians and, if present, it should be better treated in order to reduce the risk of disability and migraine frequency increase. A network of psychiatric clinics and psychologists should be developed and involved for patients suffering from cephalalgiaphobia in order to treat this disorder either pharmacologically or through psychological techniques, for example self-help group [33]. Further studies are necessary in order to investigate extensively the relationship in terms of causality between cephalalgiaphobia and increase in migraine frequency.…”

Section: Discussionmentioning

confidence: 99%

Cephalalgiaphobia as a feature of high-frequency migraine: a pilot study

et al. 2013

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BackgroundCephalalgiaphobia is the fear of having a headache attack during a pain-free period that may induce patients to use analgesic in the absence of pain to prevent headache and to improve their performances. This study aims at assessing if cephalalgiaphobia is related to migraine frequency or medication overuse, and if it is per se a predictor of increase in migraine frequency.MethodsThis is a pilot prospective cohort study on 126 consecutive migraineurs referred to a tertiary Headache Centre. A headache specialist collected data regarding migraine features, frequency and medications at baseline (T0) and 2 years later (T1). Cephalalgiaphobia was investigated at T0 and T1 through a score determined by a 4 items questionnaire.ResultsModerate-high migraine frequency was associated with higher risk of cephalalgiaphobia (p < 0.001). Chronic migraineurs with medication overuse had higher score of cephalalgiaphobia than those without medication overuse (p < 0.001). Patients with increased migraine frequency between T0 and T1 had higher cephalalgiaphobia score (p < 0.001).ConclusionsCephalalgiaphobia may represent a high-frequency migraine feature and may play a role in chronicization. Therefore, it should be better investigated by clinicians and treated or prevented in order to reduce the risk of disability and the increase in migraine frequency.

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Self-help group and medication overuse headache: preliminary data

Cited by 5 publications

References 27 publications

Treatment of medication-overuse headache: A systematic review

Treatment of medication-overuse headache: A systematic review

OnabotulinumtoxinA: An Effective Tool in the Therapeutic Arsenal for Chronic Migraine With Medication Overuse

Cephalalgiaphobia as a feature of high-frequency migraine: a pilot study

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