Self-medication of migraine and tension-type headache: summary of the evidence-based recommendations of the Deutsche Migräne und Kopfschmerzgesellschaft (DMKG), the Deutsche Gesellschaft für Neurologie (DGN), the Österreichische Kopfschmerzgesellschaft (ÖKSG) and the Schweizerische Kopfwehgesellschaft (SKG)

Haag, G.; Diener, Hans‐Christoph; May, Arne; Meyer, Christian; Morck, Hartmut; Straube, Andreas; Wessely, P; Evers, Stefan

doi:10.1007/s10194-010-0266-4

Cited by 67 publications

(54 citation statements)

References 102 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, this guideline was not based on a systematic review. The German evidence-based recommendations for self-medication of migraine and TTH were based on systematic reviews [27], and included only 7 trials that included at least some TTH patients. For self-medication of TTH, it recommended as first-line therapy the fixed-dose combination of acetaminophen, acetylsalicylic acid, and caffeine or the fixed combination of acetaminophen and caffeine as well as monotherapy with ibuprofen or acetylsalicylic acid or diclofenac.…”

Section: Discussionmentioning

confidence: 99%

“…Using previous systematic reviews [27,78] and updated searches (to January 2014), 58 reports were identified, 55 from searches and previous reviews, 2 unpublished reports from Reckitt Benckiser [55,56], and 1 clinical trial report with results from clinicaltrials.gov [53]. An additional 6 trials without results were identified on clinicaltrials.gov (Appendix 3).…”

Section: Searchingmentioning

confidence: 99%

“…We obtained copies of all of the studies included in previous systematic reviews (principally [27,78]); performed electronic searches of the literature to January 31, 2014, using PubMed, EMBASE, and Cochrane Central (Appendix 1); searched clinicaltrials.gov for any ongoing trials with results; requested clinical trial reports of unpublished studies in TTH from Reckitt Benckiser; and examined bibliographies of trials and reviews for additional studies.…”

Section: Searchingmentioning

confidence: 99%

“…Trials for the treatment of acute episodes of TTH are relatively few in number [27,78]. The trials have methodological deficiencies that may lead to bias, and the outcomes used are often complicated and rarely consistent between trials; many test drugs that are not in common use.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Evidence for efficacy of acute treatment of episodic tension-type headache: Methodological critique of randomised trials for oral treatments

Moore

Derry

Wiffen

et al. 2014

Pain

View full text Add to dashboard Cite

The International Headache Society (IHS) provides guidance on the conduct of trials for acute treatment of episodic tension-type headache (TTH), a common disorder with considerable disability. Electronic and other searches identified randomised, double-blind trials of oral drugs treating episodic TTH with moderate or severe pain at baseline, or that tested drugs at first pain onset. The aims were to review methods, quality, and outcomes reported (in particular the IHS-recommended primary efficacy parameter pain-free after 2 hours), and to assess efficacy by meta-analysis. We identified 58 reports: 55 from previous reviews and searches, 2 unpublished reports, and 1 clinical trial report with results. We included 40 reports of 55 randomised trials involving 12,143 patients. Reporting quality was generally good, with potential risk of bias from incomplete outcome reporting and small size; the 23 largest trials involved 82% of patients. Few trials reported IHS outcomes. The number needed to treat values for being pain-free at 2 hours compared with placebo were 8.7 (95% confidence interval [CI] 6.2 to 15) for paracetamol 1000 mg, 8.9 (95% CI 5.9 to 18) for ibuprofen 400mg, and 9.8 (95% CI 5.1 to 146) for ketoprofen 25mg. Lower (better) number needed to treat values were calculated for outcomes of mild or no pain at 2 hours, and patient global assessment. These were similar to values for these drugs in migraine. No other drugs had evaluable results for these patient-centred outcomes. There was no evidence that any one outcome was better than others. The evidence available for treatment efficacy is small in comparison to the size of the clinical problem.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Searchingmentioning

confidence: 99%

Section: Searchingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evidence for efficacy of acute treatment of episodic tension-type headache: Methodological critique of randomised trials for oral treatments

Moore

Derry

Wiffen

et al. 2014

Pain

View full text Add to dashboard Cite

show abstract

“…These results suggest that this cluster mainly includes rather "uncomplicated" migraine patients who seem to be able to self-treat. For these patients, evidence-based guidelines on self-medication are available [14].…”

Section: Discussionmentioning

confidence: 99%

The heterogeneity of headache patients who self-medicate: a cluster analysis approach

Mehuys

Paemeleire

Crombez

et al. 2016

PAIN

View full text Add to dashboard Cite

Patients with headache often self-treat their condition with over-the-counter analgesics. However, overuse of analgesics can cause medication-overuse headache. The present study aimed to identify subgroups of individuals with headache who self-medicate, as this could be helpful to tailor intervention strategies for prevention of medication-overuse headache. Patients (n = 1021) were recruited from 202 community pharmacies and completed a self-administered questionnaire. A hierarchical cluster analysis was used to group patients as a function of sociodemographics, pain, disability, and medication use for pain. Three patient clusters were identified. Cluster 1 (n = 498, 48.8%) consisted of relatively young individuals, and most of them suffered from migraine. They reported the least number of other pain complaints and the lowest prevalence of medication overuse (MO; 16%). Cluster 2 (n = 301, 29.5%) included older persons with mainly non-migraine headache, a low disability, and on average pain in 2 other locations. Prevalence of MO was 40%. Cluster 3 (n = 222, 21.7%) mostly consisted of patients with migraine who also report pain in many other locations. These patients reported a high disability and a severe limitation of activities. They also showed the highest rates of MO (73%).

show abstract

Aspirin with or without an antiemetic for acute migraine headaches in adults

Kirthi

Derry²,

Moore³

2013

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

BackgroundThis is an updated version of the original Cochrane review published in Issue 4, 2010 (Kirthi 2010. Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce nausea and vomiting commonly associated with migraine headaches. ObjectivesTo determine the efficacy and tolerability of aspirin, alone or in combination with an antiemetic, compared to placebo and other active interventions in the treatment of acute migraine headaches in adults. Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Oxford Pain Relief Database, ClinicalTrials.gov, and reference lists for studies through 10 March 2010 for the original review and to 31 January 2013 for the update. Selection criteriaWe included randomised, double-blind, placebo-controlled or active-controlled studies, or both, using aspirin to treat a migraine headache episode, with at least 10 participants per treatment arm. Data collection and analysisTwo review authors independently assessed trial quality and extracted data. Numbers of participants achieving each outcome were used to calculate relative risk and numbers needed to treat (NNT) or harm (NNH) compared to placebo or other active treatment. Main resultsNo new studies were found for this update. Thirteen studies (4222 participants) compared aspirin 900 mg or 1000 mg, alone or in combination with metoclopramide 10 mg, with placebo or other active comparators, mainly sumatriptan 50 mg or 100 mg. For all efficacy outcomes, all active treatments were superior to placebo, with NNTs of 8.1, 4.9 and 6.6 for 2-hour pain-free, 2-hour headache relief, and 24-hour headache relief with aspirin alone versus placebo, and 8.8, 3.3 and 6.2 with aspirin plus metoclopramide versus placebo. Sumatriptan 50 mg did not differ from aspirin alone for 2-hour pain-free and headache relief, while sumatriptan 100 mg was better than the combination of aspirin plus metoclopramide for 2-hour pain-free, but not headache relief; there were no data for 24hour headache relief.

show abstract

Cited by 67 publications

References 102 publications

Evidence for efficacy of acute treatment of episodic tension-type headache: Methodological critique of randomised trials for oral treatments

Evidence for efficacy of acute treatment of episodic tension-type headache: Methodological critique of randomised trials for oral treatments

The heterogeneity of headache patients who self-medicate: a cluster analysis approach

Aspirin with or without an antiemetic for acute migraine headaches in adults

Contact Info

Product

Resources

About