Psychiatric screening for migraine patients

Gambini, Orsola; Biagianti, Bruno; Grazzi, Licia; Usai, Susanna; Scarone, Silvio; Bussone, Gennaro

doi:10.1007/s10072-013-1359-z

Cited by 5 publications

(8 citation statements)

References 30 publications

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“…To the best of our knowledge, only a few studies (28,34,35) have evaluated changes in terms of depression and anxiety after a detoxification program according to the outcome. However, two main differences can be observed between those studies and the present one.…”

Section: Discussionmentioning

confidence: 99%

Changes in anxiety and depression symptoms associated to the outcome of MOH: A post-hoc analysis of the Comoestas Project

et al. 2017

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Aims To evaluate the impact of treatment success on depression and anxiety symptoms in medication-overuse headache (MOH) and whether depression and anxiety can be predictors of treatment outcome. Methods All consecutive patients entering the detoxification program were analysed in a prospective, non-randomised fashion over a six-month period. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. Results A total of 663 MOH patients were evaluated, and 492 completed the entire protocol. Of these, 287 ceased overuse and reverted to an episodic pattern (responders) and 23 relapsed into overuse. At the final evaluation, the number of patients with depressive symptoms was reduced by 63.2% among responders ( p < 0.001) and did not change in relapsers ( p = 0.13). Anxious symptomatology was reduced by 43.1% in responders ( ps < 0.001) and did not change in relapsers ( p = 0.69). At the multivariate analysis, intake of a prophylactic drug and absence of symptoms of depression at six months emerged as prognostic factors for being a responder (OR 2.406; p = 0.002 and OR 1.989; p = 0.019 respectively), while lack of antidepressant drugs and presence of symptoms of depression at six months were prognostic factors for relapse into overuse (OR 3.745; p = 0.004 and OR 3.439; p = 0.031 respectively). Conclusions Symptomatology referred to affective state and anxiety can be significantly reduced by the treatment of MOH. Baseline levels of depression and anxiety do not generally predict the outcome at six months. Their persistence may represent a trait of patients with a negative outcome, rather than the consequence of a treatment failure.

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Section: Discussionmentioning

confidence: 99%

Changes in anxiety and depression symptoms associated to the outcome of MOH: A post-hoc analysis of the Comoestas Project

et al. 2017

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“…patientsNo. medication overuse headacheAnalgesicsErgotsOpioidsTriptansAltieri et al 2009 [11]ItalyICHD-2 [7]Clinic2711NRNR4Ayzenberg et al 2008 [12]GermanyICHD-2 [7]Clinic2914NRNR15Biagianti et al 2012 [13]ItalyICHD-2 Revised [8]Clinic5226NRNR20Boe et al 2007 [14]NorwayICHD-2 Appendix [7]Clinic100201NR23Coppola et al 2010 [15]ItalyICHD-2 Appendix [7]Clinic2910NRNR9Cupini et al 2009 [16]ItalyICHD-2 Appendix [7]Clinic33NR1NR4Di Lorenzo et al 2009 [17]ItalyICHD-2 [7]Clinic10718NRNR29Donnet et al 2009 [18]FranceICHD-2 [7]Population320157252964Dousset et al 2013 [19]FranceICHD-2 Appendix [7]Clinic428109Galli et al 2011 [20]ItalyICHD-2Appendix [7]Clinic82212322Gambini et al 2013 [21]ItalyICHD-2 Revised [8]Clinic6333NRNR21…”

Section: Methodsmentioning

confidence: 99%

Risk of medication overuse headache across classes of treatments for acute migraine

et al. 2016

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BackgroundThe most commonly prescribed medications used to treat migraine acutely are single analgesics, ergots, opioids, and triptans. Due to varying mechanisms of action across drug classes, there is reason to believe that some classes may be less likely than others to elicit Medication Overuse Headache (MOH) than others. We therefore aimed to determine whether certain classes of acute migraine drugs are more likely to elicit MOH than others.MethodsA comprehensive systematic literature was conducted to identify studies of varying designs that reported on MOH within the considered treatment classes. Only studies that reported MOH according to the International Classification of Headache Disorders (ICHD) were considered. Since no causal comparative design studies were identified; data from prevalence studies and surveys were retrieved. Prevalence-based relative risks between treatment classes were calculated by integrating both medication overuse and medication use from published studies. For each pair wise comparison, pooled relative risks were calculated as the inverse variance weighted average.ResultsA total of 29 studies informed the relative risk between treatment classes, all of which reported country-specific data. Five studies reported country-specific medication use data. For triptans versus analgesics the study relative risks generally favored triptans. The pooled relative risk was 0.65 (i.e., relative risk reduction of 35 %). For ergots versus analgesics, a similar trend was observed in favor of ergots with a relative risk of 0.41. For triptans versus ergots, the direction of effect was mixed, and the pooled relative risk was 1.07. Both triptans and ergots appeared favorable when compared to opioids, with pooled relative risks of 0.35 and 0.76, respectively. However, the evidence was limited for these comparisons. Analgesics and opioids also appeared to yield similar risk of MOH (pooled relative risk 1.09).ConclusionOur study suggests that in patients receiving acute migraine treatment, analgesics and opioids are associated with a higher risk of developing MOH compared with other treatments. These findings provide incentive for better monitoring of use of analgesics and opioids for treating acute migraine, and suggest possible clinical preference for use of so-called “migraine-specific” treatments, that is, triptans and ergots.Electronic supplementary materialThe online version of this article (doi:10.1186/s10194-016-0696-8) contains supplementary material, which is available to authorized users.

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“…Preliminary findings from this sample regarding clinical improvements associated with detoxification were recently published [21]. For the purpose of this retrospective analysis, we focused on the following battery of assessments.…”

Section: Methodsmentioning

confidence: 99%

“…We previously conducted an observational single-arm study on subjects with CMwMO referred to our headache center for a detoxification program. When looking at migraine characteristics and related disability prior-to, and then 1-year-after detoxification, we found that detoxification was associated with significant improvements in the group taken as a whole [21]. In this retrospective analysis, we decided to study comparatively those who did not fall into medication overuse throughout the 12 months following the detoxification and those who relapsed into CMwMO.…”

Section: Introductionmentioning

confidence: 99%

Dependency-like behaviors and pain coping styles in subjects with chronic migraine and medication overuse: results from a 1-year follow-up study

Biagianti

Grazzi²,

Usai³

et al. 2014

BMC Neurol

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BackgroundEven after successful detoxification, 20-40% of subjects presenting chronic migraine with symptomatic medication overuse (CMwMO) relapse into medication overuse within one year. In this restrospective analysis on subjects referred to our center for detoxification, we investigated whether personality traits, dependency-like behaviors and pain coping styles predicted those who relapsed into medication overuse within the 12 months following the detoxification and those who did not.Methods63 patients with CMwMO were assessed for personality traits, mood and anxiety, pain coping styles and dependency-like behaviors prior-to and one year after a detoxification program.ResultsOf the 42 subjects who attended 1-year follow-up interviews, 11 relapsed into medication overuse despite a temporary benefit from detoxification and did not show clinical or psychological improvement, instead reporting increased anxiety and unmodified perpetuation of severe dependency-like behaviors. In contrast, subjects who did not relapse into medication overuse had clinical improvements that generalized to untreated domains, including decreased depressive symptoms and dependency-like behaviors, although showing unmodified low internal control over pain.ConclusionsSubjects who did not fall into medication overuse throughout the 12 months following the detoxification showed improved clinical, affective and dependence-related outcomes, but not pain coping strategies. Conversely, subjects who relapsed within one year into CMwMO continued to experience significant disability, pain intensity, and dependency-like behaviors. We believe that the persistence of maladaptive pain coping strategies and residual symptomatology increase the risk for recurrent relapses, against which pharmacological interventions are only partially effective. Further studies investigating predictors of relapse are needed to inform multi-disciplinary interventions for CMwMO.

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Psychiatric screening for migraine patients

Cited by 5 publications

References 30 publications

Changes in anxiety and depression symptoms associated to the outcome of MOH: A post-hoc analysis of the Comoestas Project

Changes in anxiety and depression symptoms associated to the outcome of MOH: A post-hoc analysis of the Comoestas Project

Risk of medication overuse headache across classes of treatments for acute migraine

Dependency-like behaviors and pain coping styles in subjects with chronic migraine and medication overuse: results from a 1-year follow-up study

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