Outcome of Medication Overuse Headache after Abrupt in-Patient withdrawal

Relja, Giuliano; Granato, Antonio; Bratina, Alessio; Antonello, Rodolfo M.; Zorzon, Marino

doi:10.1111/j.1468-2982.2006.01073.x

Cited by 41 publications

(34 citation statements)

References 30 publications

(55 reference statements)

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“…In our analysis, no difference was found between triptans and ergot derivatives concerning risk of drug dependence, although some authors previously observed that with ergotamine overuse, there was lower incidence [5], a more rapid occurrence (1.7 vs 2.7 years) [13,36], a lower monthly intake frequency [36], and a shorter time to recovery upon treatment cessation (5 vs. 10 days) [37] than with triptan overuse. This discrepancy in results may be accounted for by the longer observation period of the current study.…”

Section: Discussioncontrasting

confidence: 42%

Drug dependence associated with triptans and ergot derivatives: a case/non-case study

Beau-Salinas

Jonville-Béra

Cissoko

et al. 2009

Eur J Clin Pharmacol

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Introduction The aim of this case/non-case study was to assess and compare the risk of drug dependence associated with different migraine-specific drugs, i.e., ergot derivatives and triptans, using the French pharmacovigilance database. Methods Reports on drug side effects recorded in this database between January 1985 and June 2007 were analyzed, and triptans (almotriptan, eletriptan, naratriptan, sumatriptan, and zolmitriptan) as well as ergot derivatives used in acute migraine were examined. For all reports, cases were defined as those reports corresponding to "drug abuse," "physical or mental drug dependence," and "pharmacodependence," whereas "non-cases" were defined as all the remaining SED reports. The method's reliability was assessed by calculating the risk associated with a negative (amoxicillin) and a positive (benzodiazepines) control. The risk of dependence associated with each drug and control was evaluated by calculating the odds ratio (OR) with a confidence interval of 95%. Results Among the 309,178 reports recorded in the database, drug dependence accounted for 0.8% (2,489) of the reports, with 10.9% (449) involving a triptan, and 9.33% (332) an ergot derivative. The risk of dependence was similar for triptans and ergot derivatives and did not differ from that of benzodiazepines. In the triptan group, the risk (odds ratio [95% CI]) ranged from 10. 3 [4.8-22.3] for sumatriptan to 21.5 for eletriptan [10.1-45.6], while in the ergot derivative group, it ranged from 12 [8-17.9] for ergotamine to 20.6 [8-53] for dihydroergotamine. Conclusions These findings confirm the hypothesis that triptans and ergot derivatives are associated with an increased risk of drug dependence.

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Section: Discussioncontrasting

confidence: 42%

Drug dependence associated with triptans and ergot derivatives: a case/non-case study

Beau-Salinas

Jonville-Béra

Cissoko

et al. 2009

Eur J Clin Pharmacol

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“…While withdrawal from tripans is usually uncomplicated and generally does not require supplemental medication [68,69], withdrawal from other medication may require fluid replacement, antiemetics, mono-analgesics (naproxen 500 mg two-to three-times daily), β-blockers or even clonidine for the acute phase. A recently conducted open-label study was able to show that cortisone (oral prednisone 100 mg daily for 3 days then tapering) could considerably reduce withdrawal headache [70].…”

Section: Clinical Managementmentioning

confidence: 99%

Management of medication-overuse headache

Obermann

Katsarava

2007

Expert Review of Neurotherapeutics

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Medication-overuse headache (MOH) has developed into the third most common type of headache after tension-type headache and migraine. The prevalence reaches approximately 1% of the world's population and shows an increasing trend. Many important studies on MOH have been published in the last year, some of which investigated the pathophysiology of headache chronicity, with others focusing on the evaluation of risk factors. The International Headache Society revised its classification criteria on MOH. Several large population-based longitudinal studies clearly demonstrated that overuse of any kind of acute headache medication is the main risk factor leading to the development of chronic headache. Management of MOH remains difficult; the only effective treatment concept is consequent withdrawal therapy.

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“…Compared to barbituates and opioids, patients who overuse triptans have a quicker recovery after withdrawal and are less likely to relapse. 36 Patients who use triptans are also less likely to develop chronic migraine than patients who use opioids or barbiturate-containing medications. 37 Patients with migraine appear to be at risk for worsening of pain with increasing medication use, even compared with patients with other chronic pain disorders.…”

Section: 34mentioning

confidence: 99%

Zolmitriptan and the Triptan Era

Marmura

2009

Clinical Medicine. Therapeutics

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Zolmitriptan is one of seven triptans available to treat acute migraine attacks. The introduction of these selective serotonin receptor agonists almost 20 years ago has revolutionized acute migraine treatment. Triptans are now first line migraine drugs, and provide acute treatment that is well-tolerated, safe and effective. This commentary reviews the use of zolmitriptan and other triptans, discusses how to maximize their effect, and examines the controversies surrounding this class of medication such as medication-overuse headache, use in migraine aura or prodrome, pediatric use, and important drug interactions.

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Outcome of Medication Overuse Headache after Abrupt in-Patient withdrawal

Cited by 41 publications

References 30 publications

Drug dependence associated with triptans and ergot derivatives: a case/non-case study

Drug dependence associated with triptans and ergot derivatives: a case/non-case study

Management of medication-overuse headache

Zolmitriptan and the Triptan Era

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