Short- and Long-Term Effects of Withdrawal Therapy in Drug-Induced Headache

Author(s):  
H.-C. Diener ◽  
W. D. Gerber ◽  
S. Geiselhart ◽  
J. Dichgans ◽  
E. Scholz
2001 ◽  
Vol 45 (4) ◽  
pp. 229-235 ◽  
Author(s):  
G. Fritsche ◽  
A. Eberl ◽  
Z. Katsarava ◽  
V. Limmroth ◽  
H.C. Diener

Cephalalgia ◽  
1999 ◽  
Vol 19 (1) ◽  
pp. 44-49 ◽  
Author(s):  
B Suhr ◽  
S Evers ◽  
B Bauer ◽  
I Gralow ◽  
KH Grotemeyer ◽  
...  

Cephalalgia ◽  
1999 ◽  
Vol 19 (1) ◽  
pp. 44-49 ◽  
Author(s):  
B Suhr ◽  
S Evers ◽  
B Bauer ◽  
I Gralow ◽  
KH Grotemeyer ◽  
...  

Drug-induced headache is a well-known complication of the treatment of primary headache disorders, and its successful management is only possible by withdrawal therapy. However, it is unknown whether ambulatory or stationary withdrawal is the therapy preferred. We conducted a prospective study on the outcome of stationary versus ambulatory withdrawal therapy in patients with drug-induced headache according to the International Headache Society criteria. Out of 257 patients with the diagnosis of drug-induced headache during the study period, 101 patients (41 after ambulatory and 60 after stationary withdrawal therapy) could be followed up for 5.9 ± 4.0 years. The total relapse rate after successful withdrawal therapy was 20.8% (14.6% after ambulatory and 25.0% after stationary withdrawal therapy, p <0.2). The main risk factors for a relapse were male sex (OR=3.9, CI=1.3-11.6), intake of combined analgesic drugs (OR=3.8, CI=1.4-10.3), administration of naturopathy (OR=6.0, CI=1.2-29.3), and a trend to tension-type headache as the primary headache disorder (OR=1.9, CI=0.6-53.0). Our data suggest that neither the method of withdrawal therapy nor the kind of analgesic and other antimigraine drugs has a major impact on the long-term result after successful withdrawal therapy. Patients with risk factors according to our findings should be informed and monitored regularly, and combined drugs should be avoided. Furthermore, our data suggest that there is a need for research on individual psychological and behavioral risk factors for relapse after successful withdrawal therapy in drug-induced headache.


Author(s):  
Thomas L. Davies ◽  
Tami F. Wall ◽  
Allan Carpentier

After examination of the research carried out by other agencies, Saskatchewan Highways and Transportation (SHT) embarked on an initiative to adapt low tire pressure technologies to the province's needs and environment. The focus of the initiative was to explore several technical questions from SHT's perspective: (a) Can low tire pressures be used to increase truck weights from secondary to primary without increasing road maintenance costs on thin membrane surface roads? (b) What are the short- and long-term effects of tire heating under high-speed/high-deflection constant reduced pressure (CRP) operations in a Saskatchewan environment? (c) What effects do lower tire pressures have on vehicle stability at highway speeds? To date, significant opportunities have been noted on local hauls (less than 30 min loaded at highway speeds) for CRP operation and long primary highway hauls that begin or end in relatively short secondary highway sections that limit vehicle weight allowed for the whole trip for central tire inflation technology. The background and environment for the initiative and the investigations and demonstrations envisioned and undertaken are briefly outlined.


Author(s):  
Maria Fitzgerald ◽  
Michael W. Salter

The influence of development and sex on pain perception has long been recognized but only recently has it become clear that this is due to specific differences in underlying pain neurobiology. This chapter summarizes the evidence for mechanistic differences in male and female pain biology and for functional changes in pain pathways through infancy, adolescence, and adulthood. It describes how both developmental age and sex determine peripheral nociception, spinal and brainstem processing, brain networks, and neuroimmune pathways in pain. Finally, the chapter discusses emerging evidence for interactions between sex and development and the importance of sex in the short- and long-term effects of early life pain.


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