Subcutaneous Sumatriptan in the Treatment of Headache During Withdrawal From Drug‐Induced Headache

Abstract

In a pilot study (5 patients) we investigated the effects of subcutaneous sumatriptan, a 5-HT1-like receptor agonist, on headache experienced during the withdrawal period of drug-induced headache. The pilot study indicated that the substance was effective mostly in patients who originally suffered from migraine. In a patient with tension headache the substance was less effective. In a second double-blind study on six migraine patients with severe drug-induced headache, the drug was highly effective in ameliorating headache and autonomic disturbances. Blood flow velocities measured in extracranial parts of internal and external carotid arteries by duplex-sonography and in middle cerebral and basilar arteries by transcranial Doppler showed no changes after administration of sumatriptan or placebo. This result suggests sumatriptan does not act primarily via constriction of the large cerebral arteries.

Prednisone for the treatment of withdrawal headache in patients with medication overuse headache: A randomized, double-blind, placebo-controlled study

“…Treatment of choice for MOH is based on abrupt or gradual withdrawal of overused medication; however, this results in severe rebound headache and additional symptoms like nausea, arterial hypotension, tachycardia, sleep disturbances, anxiety, restlessness and nervousness in many patients (3). Treatment options for withdrawal headache are limited (4)(5)(6). Prednisone is suggested for treatment of withdrawal headache, but studies so far have provided mixed results (7)(8)(9)(10).…”

Medication-overuse headache

“…Older, openly conducted, but randomized studies suggested that naproxen may be better than antiemetics and other analgesics for acute treatment [34] and that sumatriptan can be helpful in the treatment of withdrawal symptoms during ergot withdrawal [35]. There have been no guidelines or consensus recommendations regarding accompanying medication during withdrawal therapy.…”

Der gordische Knoten: medikamenteninduzierte Kopfschmerzen

“…Medication overuse · Medication overuse headache · Migraine · Tension type headache · Relapse rate Gordian knot: medication overuse headache schiedliche Überbrückungstherapien mit Naproxen [22], Sumatriptan [7] oder Kortison [18] vorgeschlagen worden.…”