Reduction in medication-overuse headache after short information. The Akershus study of chronic headache

We studied secondary chronic headaches (≥ 15 days/month for at least 3 months) in a random sample of 30 000 persons aged 30-44 years. They received a mailed questionnaire. Those with self-reported chronic headache within the last month and/or year were invited to an interview and examination by a neurological resident. The criteria of the International Classification of Headache Disorders (ICHD-II) were applied. The questionnaire response rate was 71%, and the participation rate of the interview was 74%. Of the 633 participants, 298 had a secondary chronic headache. The 1-year prevalence of secondary chronic headache was 2.14%, i.e. chronic posttraumatic headache 0.21%, chronic headache attributed to whiplash injury 0.17%, post-craniotomy headache 0.02%, medication-overuse headache (MOH) 1.72%, cervicogenic headache 0.17%, headache attributed to chronic rhinosinusitis 0.33% and miscellaneous headaches 0.04%. The majority of those with ICHD-II-defined secondary chronic headache had MOH, while about one-third had other secondary headaches often in combination with MOH.

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Exploration of candidate serum biomarkers potentially related to the chronic pain condition in Medication Overuse Headache (MOH)

10.21203/rs.2.9106/v1 ◽

2019 ◽

Author(s):

Lanfranco Pellesi ◽

Elisa Bellei ◽

Simona Guerzoni ◽

Maria Michela Cainazzo ◽

Carlo Baraldi ◽

...

Keyword(s):

Neuropathic Pain ◽

Correlation Coefficient ◽

Trigeminal Nerve ◽

Chronic Headache ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Serum Levels ◽

Apolipoprotein A1 ◽

Serum Concentrations ◽

Healthy Individuals

Abstract Background Medication Overuse Headache (MOH) is a prevalent and disabling disorder resulting from the overuse of analgesic drugs, triptans or other acute headache medications. In previous proteomic studies, several proteins have been found at high concentrations in the urine of MOH patients and in the serum of rats with neuropathic pain. The aim of this study was to compare the serum levels of lipocalin-type Prostaglandin D2 synthase (L-PGDS), Vitamin D-binding protein (VDBP), apolipoprotein E (APOE) and apolipoprotein A1 (APOA1) in MOH patients and healthy individuals, further exploring their relationship with cutaneous pain thresholds (CPTs) in the territories innervated by the trigeminal nerve. Methods 69 MOH patients and 42 age- and sex-matched healthy volunteers were enrolled in the study. Von Frey-like filaments were applied to the skin territories innervated by the trigeminal nerve, to determine the CPTs. L-PGDS, VDBP, APOE and APOA1 were quantified in the serum by Enzyme-linked Immunosorbent Assay (ELISA). Clinical and laboratory data were collected. Comparisons between MOH patients and healthy individuals were performed using independent t test or χ2 test. To correlate serum proteins with CPTs, Pearson correlation coefficient or Spearman's rank correlation coefficient were used. Results CPTs were lower among MOH patients. L-PGDS, VDBP and APOE had significantly different serum concentrations between groups (p < 0.01), but no correlation was found with CPTs. APOA1 serum concentrations did not differ between patients and healthy individuals. Conclusions L-PGDS, VDBP and APOE had abnormal serum levels in MOH patients, confirming their alteration in some conditions of chronic headache and neuropathic pain. The in-depth study of target proteins represents a promising approach for a better understanding of MOH, as well as the detection of candidate biomarkers for chronic headache or the risks associated with overuse medications.

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Remission of chronic headache: An 11-year follow-up study. Data from the Nord-Trøndelag Health Surveys 1995–1997 and 2006–2008

Cephalalgia ◽

10.1177/0333102418769940 ◽

2018 ◽

Vol 38 (14) ◽

pp. 2026-2034 ◽

Cited By ~ 2

Author(s):

Knut Hagen ◽

Espen Saxhaug Kristoffersen ◽

Bendik Slagvold Winsvold ◽

Lars Jacob Stovner ◽

John-Anker Zwart

Keyword(s):

Cohort Study ◽

Chronic Headache ◽

Response Rate ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Population Based ◽

Study Data ◽

Health Study ◽

Musculoskeletal Complaints

Objectives To estimate remission rates of chronic headache and predictors of remission. Methods In this longitudinal population-based cohort study, we used validated headache questionnaire data from the second (1995–1997, baseline; n = 51,856 aged ≥ 20 years, response rate: 55%) and third wave (2006–2008, follow-up, response rate: 42%) of the Nord-Trøndelag Health Study. Chronic headache was defined as ≥15 headache days/month during the last year. Chronic headache remission was defined as headache less than 15 days/month at follow-up. Potential predictors of remission were evaluated using logistic regression. Results At baseline, 1266 (2.4%) participants reported chronic headache. Of these, 605 (48%) answered headache questions at follow-up. Remission was observed in 452 (74.7%), the proportion being almost identical in men and women (74.4% vs. 74.9, p = 0.92). In analyses adjusting for age, gender and education level, remission at follow-up was more than two times more likely among individuals without medication overuse headache (OR = 2.4, 95% CI 1.7–3.6) and without chronic musculoskeletal complaints (OR = 2.9, 95% CI 1.5–5.0) at baseline. Conclusions In this longitudinal population-based cohort study, three-quarters of chronic headache participants remitted from chronic headache. Remission was associated with no medication overuse headache and no chronic musculoskeletal complaints at baseline.

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Medication overuse and drug addiction: a narrative review from addiction perspective

The Journal of Headache and Pain ◽

10.1186/s10194-021-01224-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Tatiane Teru Takahashi ◽

◽

Raffaele Ornello ◽

Giuseppe Quatrosi ◽

Angelo Torrente ◽

...

Keyword(s):

High Risk ◽

Drug Addiction ◽

Chronic Headache ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Medication Use ◽

Primary Headache ◽

Point Of View ◽

Secondary Headache ◽

Acute Migraine

AbstractChronic headache is particularly prevalent in migraineurs and it can progress to a condition known as medication overuse headache (MOH). MOH is a secondary headache caused by overuse of analgesics or other medications such as triptans to abort acute migraine attacks. The worsening of headache symptoms associated with medication overuse (MO) generally ameliorates following interruption of regular medication use, although the primary headache symptoms remain unaffected. MO patients may also develop certain behaviors such as ritualized drug administration, psychological drug attachment, and withdrawal symptoms that have been suggested to correlate with drug addiction. Although several reviews have been performed on this topic, to the authors best knowledge none of them have examined this topic from the addiction point of view. Therefore, we aimed to identify features in MO and drug addiction that may correlate. We initiate the review by introducing the classes of analgesics and medications that can cause MOH and those with high risk to produce MO. We further compare differences between sensitization resulting from MO and from drug addiction, the neuronal pathways that may be involved, and the genetic susceptibility that may overlap between the two conditions. Finally, ICHD recommendations to treat MOH will be provided herein.

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MEDICATION OVERUSE HEADACHE, WHY IT HAPPENED?

Human Care Journal ◽

10.32883/hcj.v5i1.658 ◽

2020 ◽

Vol 5 (1) ◽

pp. 391

Author(s):

Restu Susanti

Keyword(s):

Quality Of Life ◽

Early Diagnosis ◽

Chronic Headache ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Secondary Headache ◽

Headache Attack ◽

Inflammatory Drugs ◽

Anti Inflammatory

Medication Overuse Headache (MOH) is a secondary headache -- worsening condition of preexisting headache (usually primary hedache). MOH occurs due to medication overuse to relief the pain or to treat the headache attack. The etiology of MOH is the excessive use of single and combined analgesics, nonsteroidal anti-inflammatory drugs, caffeine, opioids, ergotamine, triptans and barbiturates. MOH is a chronic headache which need to recognize early. Diagnosis, accurate therapy, and management of comorbidities must be done to improve patient’s productivity and quality of life.

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Medication Overuse Headache and Myofascial Pain: Frequent Under-Diagnosed Conditions Related to Chronic Headache Patients. A Re-view of The Literature and Clinical Report

Kapadokya Üniversitesi ◽

10.54995/asc.1.1.6 ◽

2021 ◽

Vol 1 (1) ◽

pp. 68-80

Author(s):

Paula Volpato Sanitá ◽

Andréa Masseli ◽

Francisco Alencar

Keyword(s):

Chronic Headache ◽

Myofascial Pain ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Clinical Report ◽

Headache Patients

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The lived experience of chronic headache: a systematic review and synthesis of the qualitative literature

BMJ Open ◽

10.1136/bmjopen-2017-019929 ◽

2017 ◽

Vol 7 (12) ◽

pp. e019929 ◽

Cited By ~ 14

Author(s):

Vivien P Nichols ◽

David R Ellard ◽

Frances E Griffiths ◽

Atiya Kamal ◽

Martin Underwood ◽

...

Keyword(s):

Systematic Review ◽

Lived Experience ◽

Thematic Analysis ◽

Chronic Headache ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Headache Disorder ◽

Headache Disorders ◽

Chronic Headaches ◽

Qualitative Literature

ObjectiveTo systematically review the qualitative literature of the lived experience of people with a chronic headache disorder.BackgroundChronic headaches affect 3%–4% of the population. The most common chronic headache disorders are chronic migraine, chronic tension-type headache and medication overuse headache. We present a systematic review and meta-ethnographic synthesis of the lived experience of people with chronic headache.MethodsWe searched seven electronic databases, hand-searched nine journals and used a modified Critical Appraisal Skills Programme checklist to appraise study quality. Following thematic analysis we synthesised the data using a meta-ethnographic approach.ResultsWe identified 3586 unique citations; full texts were examined for 86 studies and 4 were included in the review. Included studies differed in their foci: exploring, patient-centred outcomes, chronic headache as a socially invisible disease, psychological processes mediating impaired quality of life, and the process of medication overuse. Initial thematic analysis and subsequent synthesis gave three overarching themes: ‘headache as a driver of behaviour’ (directly and indirectly), ‘the spectre of headache’ and ‘strained relationships’.ConclusionThis meta-synthesis of published qualitative evidence demonstrates that chronic headaches have a profound effect on people’s lives, showing similarities with other pain conditions. There were insufficient data to explore the similarities and differences between different chronic headache disorders.

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Monitoring chronic headache and medication-overuse headache prevalence in Denmark

Cephalalgia ◽

10.1177/0333102419876909 ◽

2019 ◽

Vol 40 (1) ◽

pp. 6-18 ◽

Cited By ~ 4

Author(s):

Maria Lurenda Westergaard ◽

Cathrine Juel Lau ◽

Karen Allesøe ◽

Signe Thorup Gjendal ◽

Rigmor Højland Jensen

Keyword(s):

Chronic Headache ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Cross Sectional Study ◽

Self Report ◽

Opioid Use ◽

Cross Sectional ◽

Pain Medications ◽

High Prevalence ◽

Survey Responses

Objectives To study chronic headache and medication-overuse headache (MOH) prevalence; to identify groups with high prevalence of these conditions; and to identify the most frequently used pain medications among respondents with chronic headache. Background Chronic headache and MOH prevalence in Denmark were last estimated in 2010. Methods In this cross-sectional study, 104,950 individuals aged ≥16 years were randomly sampled for the 2017 Danish Capital Region Health Survey. Responses to questions about headache and use of acute pain medications were linked to demographic registries. MOH was defined as headache ≥15 days/month plus self-report of use of pain medications ≥10 or 15 days/month, in the last three months. Weighted prevalence proportions were calculated. Results Among 55,185 respondents, chronic headache prevalence was 3.0% (95% CI: 2.3–3.2) and MOH prevalence was 2.0% (95% CI: 1.8–2.1). Both conditions were more common among females and the middle-aged. Respondents on social welfare or receiving early retirement pensions had the highest prevalences. Among those with chronic headache, 44.7% overused over-the-counter analgesics for headache; paracetamol 41.5%; a combination of different pain relievers 25.3%; ibuprofen 21.9%; opioids 17.0%; combination preparations 14.3%; and triptans 9.1%. Conclusions The highest prevalence of chronic headache and MOH was seen among people with low socioeconomic position. Overuse of paracetamol was most common. Reported opioid use was higher than expected. Groups with high prevalence of MOH should be the focus of public health interventions on rational use of OTC and prescription pain medications.

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Migraine, tension-type headache and medication-overuse headache in a large population of shift working nurses: a cross-sectional study in Norway

BMJ Open ◽

10.1136/bmjopen-2018-022403 ◽

2018 ◽

Vol 8 (11) ◽

pp. e022403 ◽

Cited By ~ 9

Author(s):

Bjørn Bjorvatn ◽

Ståle Pallesen ◽

Bente E Moen ◽

Siri Waage ◽

Espen Saxhaug Kristoffersen

Keyword(s):

Shift Work ◽

Chronic Headache ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Tension Type Headache ◽

Work Schedule ◽

Shift Work Disorder ◽

Insomnia Disorder ◽

Type Headache ◽

Night Shifts

ObjectivesTo investigate associations between different types of headaches and shift work.Design, participants and outcome measuresNurses with different work schedules (day work, two-shift rotation, night work, three-shift rotation) participated in a cohort study with annual surveys that started in 2008/2009. In 2014 (wave 6), a comprehensive headache instrument was included in the survey, in which 1585 nurses participated. Headaches were assessed according to the International Classification of Headache Disorders IIIb. Frequent headache (≥1 day per month), migraine, tension-type headache, chronic headache (headache >14 days per month) and medication-overuse headache (chronic headache + acute headache medication ≥10 days last month) comprised the dependent variables. Adjusted (for sex, age, percentage of full-time equivalent, marital status, children living at home) logistic regression analyses were conducted with work schedule, number of night shifts worked last year, number of quick returns (<11 hours in-between shifts) last year, shift work disorder and insomnia disorder as predictors.ResultsFrequent headache, migraine and chronic headache were associated with shift work disorder (OR 2.04, 95% CI 1.62 to 2.59; 1.60, 1.21 to 2.12; 2.45, 1.25 to 4.80, respectively) and insomnia disorder (OR 1.79, 95% CI 1.43 to 2.23; 1.55, 1.18 to 2.02; 3.03, 1.54 to 5.95, respectively), but not with work schedule, number of night shifts or number of quick returns. Tension-type headache was only associated with >20 night shifts last year (OR 1.41, 95% CI 1.07 to 1.86). Medication-overuse headache was only associated with insomnia disorder (OR 7.62, 95% CI 2.48 to 23.41).ConclusionsWe did not find any association between different types of headaches and work schedule. However, tension-type headache was associated with high number of night shifts. Nurses with sleep disorders (insomnia disorder and shift work disorder) reported higher prevalence of frequent headaches, migraine, chronic headache and medication-overuse headache (only insomnia) compared with nurses not having insomnia disorder and shift work disorder, respectively.

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Medication Overuse Headache: Clinical Features Predicting Treatment Outcome at 1-Year Follow-Up

Cephalalgia ◽

10.1111/j.1468-2982.2007.01432.x ◽

2007 ◽

Vol 27 (11) ◽

pp. 1219-1225 ◽

Cited By ~ 57

Author(s):

J Zidverc-Trajkovic ◽

T Pekmezovic ◽

Z Jovanovic ◽

A Pavlovic ◽

M Mijajlovic ◽

...

Keyword(s):

Chronic Headache ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Age At Onset ◽

Primary Headache ◽

Headache Disorder ◽

Primary Headache Disorder ◽

A Prospective Study ◽

Predicting Treatment Outcome

We present a prospective study of 240 patients with medication overuse headache (MOH) treated with drug withdrawal and prophylactic medications. At 1-year follow-up, 137 (57.1%) patients were without chronic headache and without medication overuse, eight (3.3%) patients did not improve after withdrawal and 95 (39.6%) relapsed developing recurrent overuse. Age at time of MOH diagnosis, regular use of benzodiazepines, frequency and Migraine Disability Assessment (MIDAS) score of chronic headache, age at onset of primary headache, frequency and MIDAS score of primary headache, ergotamine compound overuse and daily drug intake were significantly different between successfully and unsuccessfully treated patients. Multivariate analysis determined the frequency of primary headache disorder, ergotamine overuse and disability of chronic headache estimated by MIDAS as independent predictors of treatment efficacy at 1-year follow-up.

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