Does Analgesic Abuse Cause Headaches De Novo?

Lance, F.; Parkes, C.; Wilkinson, Matthew

doi:10.1111/j.1526-4610.1988.hed2801060_2.x

Cited by 116 publications

(61 citation statements)

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“…Patients with migraine and tension-type headache have a higher potential for medicationoveruse headache [11], and relapses of migraine occur in migraineurs who have been placed on analgesics for other ailments. On the contrary, chronic overuse of analgesics does not cause increased headache in non-migraineurs [12,13]. Patients with analgesic-overuse headache have a different psychologic substrate than psychiatric substance abusers, although psychiatric assessment and support may be beneficial for them [14].…”

Section: Discussionmentioning

confidence: 99%

Medication-overuse headache: citalopram associated with analgesics withdrawal as possible treatment

et al. 2003

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Medication-overuse headaches are a relevant medical and social problem, for which specific treatments have not yet been defined. In patients with chronic daily headache who take analgesics every day, this headache is most likely to be caused by drugs and will vanish with abstinence. Nonetheless, there is anecdotal evidence that selective serotonin reuptake inhibitors (SSRI) are effective in chronic daily headache, because of the concomitant presence of psychiatric comorbidities (depression, anxiety, or a combination of both). Six migraineurs were admitted to the Neurology Clinic for medicationoveruse headache and associated depression, anxiety and behavioural changes. Treatment consisted in suppressing other drugs and by using an SSRI, citalopram, at modest dosage (≤30 mg daily). Analgesic withdrawal was performed in hospital and was not particularly problematic. Over a 1-year follow-up, pain coping strategies ameliorated and depression decreased; drug withdrawal was easy, even from barbiturates, and pain control was good. Further investigation into the possible use of citalopram or other SSRIs in medication-overuse headache is waranted.

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Section: Discussionmentioning

confidence: 99%

Medication-overuse headache: citalopram associated with analgesics withdrawal as possible treatment

et al. 2003

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“…The preexisting condition required to develop MOH is usually a primary headache, such as migraine of TTH. However, there is evidence that also patients affected by secondary headache disorders as post-traumatic headache [21,[23][24][25] can present with MOH. If drug overuse is required to develop MOH, several risk factors have been also described that may predispose or aggravate the condition.…”

Section: Drug Overusementioning

confidence: 99%

Chronic headaches and medication overuse

et al. 2010

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Chronic headaches represent a significant burden for the affected individuals and for the society, and a major challenge for successful care. Among the various types of chronic headaches, those that are associated with medication overuse (medication-overuse headache, MOH) are of particular importance because of the large proportion of patients who complain of this condition and their poor outcome. Most patients with MOH had migraine as primary headache. Practically, almost all drugs used for the symptomatic relief of migraine, including triptans and analgesics can cause MOH. Although the pathophysiology of MOH is unknown, recent studies hypothesize that plastic changes in specific pain areas of the central nervous system are main contributors to establishing MOH. Not infrequently, drug overuse is associated with habituation and failure of previously effective medications. Finally, treatment of MOH is poorly evidence based and mostly relies on clinical experience and belief.

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“…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 .…”

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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Does Analgesic Abuse Cause Headaches De Novo?

Cited by 116 publications

References 0 publications

Medication-overuse headache: citalopram associated with analgesics withdrawal as possible treatment

Medication-overuse headache: citalopram associated with analgesics withdrawal as possible treatment

Chronic headaches and medication overuse

Cefalea crónica diaria con Abuso de Analgésicos

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