Polypharmacy in a Headache Centre Population

Oates, Linda N.; Scholz, Mary; Hoffert, Marvin Jay

doi:10.1111/j.1526-4610.1993.hed3308436.x

Cited by 14 publications

(7 citation statements)

References 1 publication

(1 reference statement)

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“…Polypharmacy is common in a Headache Centre population. 14 In the case of CM group (Fig. 4), where 73% of the patients were daily taking nonheadache drugs, above all sedativehypnotics (30%), followed by antihypertensive agents (26%) and antidepressants (23%), polypharmacy was probably a consequence of their comorbid diseases and the result of their frequent and different consultations.…”

Section: Commentsmentioning

confidence: 97%

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Similarities and Differences Between Chronic Migraine and Episodic Migraine

Ferrari¹,

Leone²,

Vergoni³

et al. 2006

Headache

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Objective.-To quantify and characterize the similarities and the differences between chronic migraine (CM) patients with medication overuse and episodic migraine (EM) patients with only occasional analgesic use. Background.-Population-level epidemiology, characteristics, mechanisms of chronic daily headache, and medication-overuse headache have been widely studied but patient characteristics have received less attention.Methods.-We compared sociodemographic data, family history, physiological and medical history, health services utilized, drugs taken/prescribed, and outcome of 2 groups of subjects: 150 patients, suffering from CM, complicated by probable medication-overuse headache (CM group), consecutively admitted during 2005 to the inpatients' ward of the Headache Centre of the University Hospital of Modena and Reggio Emilia, Italy, to undergo withdrawal from their overused medications; 100 patients suffering from EM, uncomplicated by medication overuse (EM group), consecutively referred to the outpatients' ward of the Headache Centre during November and December 2005.Results.-All sociodemographic characteristics were significantly different between the 2 groups. As a whole, the CM group began to suffer from migraine earlier than the EM group. Drug and/or alcohol abuse was significantly higher among first-degree relatives of CM (19%) than of EM (6%) patients. The most frequent comorbid disorders were psychiatric (67%) and gastrointestinal diseases (43%) in the CM group, and allergies in the EM group (31%). Seventy percent of CM patients and 42% of EM patients were taking daily at least another drug, besides those for headache treatment. Most overused medications in the CM group were triptans (43%); the EM group used above all single NSAIDs (56%). At 3-month follow-up, prophylactic treatments reduced, by at least 50%, the frequency of headache in about three-fourths of patients of both the groups; however, headache remained significantly more frequent in the CM than in EM group: only a minority (15%) of CM patients reverted to a headache frequency comparable to that of the EM group.Conclusions.-CM patients present more multiple comorbid disorders, polypharmacy, and social impediments than EM patients. These associated conditions complicate CM clinical management. Even after withdrawal from medication overuse, CM could not be completely reverted by current prophylactic treatments.

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Section: Commentsmentioning

confidence: 97%

“…3) suffered above all from psychiatric disorders (67%) (anxiety and depression), followed by gastrointestinal disorders (43%), perhaps due to the overuse of NSAIDs, alone or combined. Polypharmacy is common in a Headache Centre population 14 . In the case of CM group (Fig.…”

Section: Commentsmentioning

confidence: 99%

Similarities and Differences Between Chronic Migraine and Episodic Migraine

Ferrari¹,

Leone²,

Vergoni³

et al. 2006

Headache

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“…A clinic‐based study by Oates et al found that 69% of headache patients were on one or more medication that was not intended for headache prevention 15 . Many of these non‐headache prescriptions were substances that impacted preventative therapy such as hormones, antidepressants, and antihistamines.…”

Section: When To Consider Combination Therapymentioning

confidence: 99%

Rational Combination Therapy in Refractory Migraine

Peterlin

Calhoun

Siegel³

et al. 2008

Headache

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Refractory migraine (RM) headaches pose important treatment challenges to the patients who live with them and the clinicians who try to treat them. Defined based on the lack of response to acute, preventive, and nonpharmacologic treatment, RM is often treated with a combination of treatments. Although combination therapy for RM has not been systematically studied in randomized trials, clinical experience suggests that a rational approach to RM treatment, utilizing a combination of treatments, may be effective where monotherapy has failed. In this article we briefly identify patient populations appropriate for more aggressive migraine prevention with combination therapy. We then discuss modifiable risk factors and comorbidities in migraine and then focus on the use of rational combination therapy, as well as the duration migraine preventatives should be considered for use. Future research is needed to evaluate the full potential of rational combination treatment as a strategy for treating and ultimately preventing RM.

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“…In Heinisch's 4 study, self‐medication was reported by 89.9% of those interviewed, while the medication was prescribed by a physician in only 8.8% of the cases. Oates et al 17 found that 69% of the patients treated at the Graham Headache Center of the Faulkner Hospital in Boston used medications not prescribed to them. Amayo et al 3 concluded from the results of their research that the main reason for not consulting a doctor for headache was self‐medication; this occurred in 56% of the students with headaches.…”

Section: Commentsmentioning

confidence: 99%

Frequency of Headache in the Medical Students of Santa Catarina's Federal University

et al. 2000

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Studies in well-defined populations are useful in identifying factors that influence frequency and severity of headache and in understanding its impact on people. The aims of this study were to determine the frequency of headache in the medical students of Santa Catarina's Federal University, examine associated factors, verify the diagnostic impressions of the different types of headache, and describe the self-medication level. This study included 408 medical students who were interviewed by a questionnaire from October 1997 to August 1998. The frequency of headache in this group was 33%, with women and students in the five last semesters of the medical course experiencing increased headache frequency. The diagnostic impressions of the different types of headache were migraine without aura (31.3%), migraine with aura (8.2%), episodic tension-type headache (32.1%), chronic tension-type headache (7.5%), and tension-type headache combined with migraine without aura (3%). Self-medication was reported by 51.8% of the medical students with headache; 34.4% used prescribed medications. The most common self-help techniques used by students during a headache were to lie down or isolate themselves from their surroundings.

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Polypharmacy in a Headache Centre Population

Cited by 14 publications

References 1 publication

Similarities and Differences Between Chronic Migraine and Episodic Migraine

Similarities and Differences Between Chronic Migraine and Episodic Migraine

Rational Combination Therapy in Refractory Migraine

Frequency of Headache in the Medical Students of Santa Catarina's Federal University

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