scholarly journals Psychological, clinical, and therapeutic predictors of the outcome of detoxification in a large clinical population of medication-overuse headache: A six-month follow-up of the COMOESTAS Project

Cephalalgia ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 135-147 ◽  
Author(s):  
Sara Bottiroli ◽  
Marta Allena ◽  
Grazia Sances ◽  
Roberto De Icco ◽  
Micol Avenali ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Odds Ratio ◽  
Chronic Headache ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Tension Type Headache ◽  
Outcome Evaluation ◽  
Type Headache

Aim To identify factors that may be predictors of the outcome of a detoxification treatment in medication-overuse headache. Methods Consecutive patients entering a detoxification program in six centres in Europe and Latin America were evaluated and followed up for 6 months. We evaluated anxious and depressive symptomatology (though patients with severe psychiatric comorbidity were excluded), quality of life, headache-related disability, headache characteristics, and prophylaxis upon discharge. Results Of the 492 patients who completed the six-month follow up, 407 ceased overuse following the detoxification (non overusers), another 23 ceased overuse following detoxification but relapsed during the follow-up. In the 407 non-overusers, headache acquired an episodic pattern in 287 subjects (responders). At the multivariate analyses, lower depression scores (odds ratio = 0.891; p = 0.001) predicted ceasing overuse. The primary headache diagnosis – migraine with respect to tension-type headache (odds ratio = 0.224; p = 0.001) or migraine plus tension-type headache (odds ratio = 0.467; p = 0.002) – and the preventive treatment with flunarizine (compared to no such treatment) (odds ratio = 0.891; p = 0.001) predicted being a responder. A longer duration of chronic headache (odds ratio = 1.053; p = 0.032) predicted relapse into overuse. Quality of life and disability were not associated with any of the outcomes. Conclusions Though exploratory in nature, these findings point to specific factors that are associated with a positive outcome of medication-overuse headache management, while identifying others that may be associated with a negative outcome. Evaluation of the presence/absence of these factors may help to optimize the management of this challenging groups of chronic headache sufferers.

Complete withdrawal is the most effective approach to reduce disability in patients with medication-overuse headache: A randomized controlled open-label trial

Cephalalgia ◽  
2019 ◽  
Vol 39 (7) ◽  
pp. 863-872 ◽  
Author(s):  
Mia Nielsen ◽  
Louise Ninett Carlsen ◽  
Signe Bruun Munksgaard ◽  
Ida Maria Storm Engelstoft ◽  
Rigmor Højland Jensen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Tension Type Headache ◽  
Response To Treatment ◽  
Open Label ◽  
Significant Difference ◽  
Headache Patients

Background Medication-overuse headache leads to high disability and decreased quality of life, and the best approach for withdrawal has been debated. Aim To compare change in disability and quality of life between two withdrawal programs. Methods We randomized medication-overuse headache patients to program A (two months without acute analgesics or migraine medications) or program B (two months with acute medications restricted to two days/week) in a prospective, outpatient study. At 6 and 12 months, we measured disability and headache burden by the Headache Under-Response to Treatment index (HURT). We estimated quality of life by EUROHIS-QOL 8-item at 2-, 6-, and 12-month follow-up. Primary endpoint was disability change at 12 months. Results We included 72 medication-overuse headache patients with primary migraine and/or tension-type headache. Fifty nine completed withdrawal and 54 completed 12-month follow-up. At 12-month follow-up, 41 patients completed HURT and 38 completed EUROHIS-QOL 8-item. Disability reduction was 25% in program-A and 7% in program-B ( p = 0.027). Headache-burden reduction was 33% in program-A and 3% in program-B ( p = 0.005). Quality of life was increased by 8% in both programs without significant difference between the programs ( p = 0.30). At 2-month follow-up, quality of life increased significantly more in program-A than program-B ( p = 0.006). Conclusion Both withdrawal programs reduced disability and increased quality of life. Withdrawal without acute medication was the most effective in reducing disability in medication-overuse headache patients. Trial registration Clinicaltrials.gov (NCT02903329).

scholarly journals MEDICATION OVERUSE HEADACHE, WHY IT HAPPENED?

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

<p><em>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 </em><em>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. </em></p>

Headache in children: Effectiveness of multidisciplinary treatment in a tertiary paediatric headache clinic

Cephalalgia ◽  
2013 ◽  
Vol 33 (15) ◽  
pp. 1218-1228 ◽  
Author(s):  
Ann-Britt L Soee ◽  
Liselotte Skov ◽  
Lene Theil Skovgaard ◽  
Lise L Thomsen
Keyword(s):  
Chronic Headache ◽  
Medication Overuse Headache ◽  
Multidisciplinary Treatment ◽  
Tension Type Headache ◽  
Headache Frequency ◽  
Measurement Analysis ◽  
Headache Clinic ◽  
Type Headache

Aim The aim of this article is to evaluate the effectiveness of a specific multidisciplinary treatment programme for children with headache and to describe the concept and settings of the Children’s Headache Clinic in Denmark. Method All new patients were included and evaluations were conducted after six and 12 months. Pharmacological and non-pharmacological treatments were offered by a team of specialists (physicians, headache nurses, a physiotherapist and a psychologist). Patients The subjects comprised 169 children (mean age 11.7 (range 4–17), 91 females, 78 males), 39% of whom suffered from chronic headache (≥15 days/month). All children were diagnosed according to the International Classification of Headache Disorders, second edition; 20% had migraine, 34% tension-type headache, 27% mixed headache, 4% medication-overuse headache, and 15% were diagnosed with other types of headaches. Results Fifty per cent of the children had an improvement in headache frequency above 50% at six months. By the use of repeated measurement analysis, we found a significant decrease in headache frequency in all of the six headache groups, whereas the increase in quality of life (PedsQL™ 4.0) was significant for the group as a whole. Conclusion Though preliminary, the results show a good outcome for multidisciplinary treatment programmes for children who suffer from frequent or chronic headache.

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

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e022403 ◽  
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.

Medication Overuse Headache: Rates and Predictors for Relapse in a 4-year Prospective Study

Cephalalgia ◽  
2005 ◽  
Vol 25 (1) ◽  
pp. 12-15 ◽  
Author(s):  
Z Katsarava ◽  
M Muessig ◽  
A Dzagnidze ◽  
G Fritsche ◽  
HC Diener ◽  
...  
Keyword(s):  
Prospective Study ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Primary Headache ◽  
Tension Type Headache ◽  
First Year ◽  
Follow Up Study ◽  
Type Headache

We present a prospective 4-year follow-up study of 96 patients with medication overuse headache following withdrawal. Complete datasets were available from 85 patients (89%) 6 months, from 79 patients (82%) 1 year and from 75 patients (78%) 4 years after withdrawal. Twenty-six patients (31%) relapsed within the first 6 months after withdrawal. The number of relapses increased to 32 (41%) 1 year and to 34 (45%) 4 years after withdrawal. The 4-year relapse rate was lower in migraine than in tension-type headache (32% vs. 91%, P ≤ 0.001) and combination of migraine and tension-type headache (32% vs. 70%, P ≤ 0.027) and also lower in patients overusing triptans than analgesics (21% vs. 71%, P ≤ 0.001). The study suggests that the majority of relapses occur within the first year after withdrawal and that the long-term success of withdrawal depends on the type of primary headache and the type of overused medication.

scholarly journals Health-related quality of life in tension-type headache: a population-based study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sait Ashina ◽  
Dawn C. Buse ◽  
Jakob B. Bjorner ◽  
Lars Bendtsen ◽  
Ann C. Lyngberg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Eysenck Personality Questionnaire ◽  
Health Related Quality ◽  
Self Rated Health ◽  
Related Quality ◽  
Health Related ◽  
Type Headache

Abstract Objectives Tension-type headache (TTH) is the most prevalent primary headache disorder. We assessed the cross-sectional impact of TTH on health related quality of life (HRQoL) in a general population. We also examined the association of HRQoL scores with headache frequency, disability, medication overuse, poor self-rated health, psychiatric comorbidity, and pain sensitivity in individuals with TTH. Methods A sample of 547 subjects completed a headache diagnostic interview, the SF-12 to calculate physical (PCS) and mental (MCS) health component scores, depression (major depression inventory [MDI]) and neuroticism (Eysenck Personality Questionnaire) measures. We defined the following headache diagnosis categories: pure TTH, pure migraine, and coexistent headache (TTH + migraine). Cases were further classified into chronic (≥15) or episodic (<15 headache days/month). Results Using generalized linear models (GLM) adjusted for age, sex and education, both PCS-12 and MCS-12 scores varied in groups distinguished by migraine and TTH status; scores were lower for individuals with coexistent headache (TTH + migraine; n=83), followed by pure TTH (n=97) and pure migraine (n=43) compared to the no headache group (n=324) (p≤0.001). In analyses considering chronicity, PCS-12 scores were lower in chronic coexistent headache followed by pure chronic TTH (CTTH), episodic migraine +/− episodic TTH (ETTH) and pure ETTH than in the no headache group (p≤0.001). MCS-12 scores were lower in pure CTTH, followed by chronic coexistent headache, episodic migraine +/− ETTH and pure ETTH compared to the no headache group (p≤0.001). Multiple regression models showed that in TTH, lower PCS-12 scores were associated with age (p=0.04), female sex (p=0.02), and poor self-rated health (p≤0.001). Lower MCS-12 scores in TTH were associated with depression (p≤0.001). Conclusions In a population sample, TTH, and to higher degree CTTH, are associated with decreased HRQoL.

Frequency of diagnoses in a specialized headache clinic in Buenos Aires

2019 ◽  
pp. 66-69
Author(s):  
Vanessa Nagel ◽  
Sol Cavanagh ◽  
Marina Olivier ◽  
Natalia Larripa ◽  
Maria T Gutierrez ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Buenos Aires ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Craniofacial Pain ◽  
Headache Clinic ◽  
Type Headache

Objective: Headache is one of the most frequent reason for consultations in neurology. The global prevalence among adults with migraine is approximately 10% with migraine, 40% for tension-type headache (TTH) and 3% for chronic daily headache. The purpose of this study is to analyze the prevalence of the diagnoses of headache and craniofacial pain among patients evaluated in a specialized headache clinic of Buenos Aires during 2017. Methods: Retrospective, descriptive study. We reviewed the electronic medical records of patients who consulted for headaches or craniofacial pain from January 1st to December 31st, 2017. Diagnoses were made according to the criteria of the International Classification of Headache Disorders (ICHD-3). Results: We reviewed 3254 electronic medical records and documented 3941 diagnoses: headache (93.03%), craniofacial pain (3.62%) and unclassifiable (3.35%). The average age was 43.14 years. 80.7% were women. Primary headaches were the most frequent diagnoses (78.54%). Migraine represented the main diagnosis (87.42%). Episodic migraine without aura was the most prevalent diagnosis (48%). Tension- type headache (TTH) was found in 8.74% of cases of primary headaches and Trigeminal autonomic cephalalgias (TACs) in 2.89%. Medication-overuse headache (MOH) represented 77.93% of the secondary headaches, and most of them also met chronic migraine criteria fulfilled criteria of chronic migraine. Primary trigeminal neuralgia represented 50% of craniofacial pain and 27% were secondary trigeminal neuralgia, mostly postherpetic or posterior to dental procedures. Regardin to the frecuency, 33.58% of the patients had chronic headache. Conclusion: In our section, migraine is the most frequent diagnosis followed by medication-overuse headache. The percentage of chronic headache is higher than the prevalence in the general population, probably because it is a tertiary center.

Medication overuse headache in 787 patients admitted for inpatient treatment over a period of 32 years

Cephalalgia ◽  
2020 ◽  
Vol 40 (8) ◽  
pp. 808-817 ◽  
Author(s):  
Sabine Salhofer-Polanyi ◽  
Karin Zebenholzer ◽  
Thomas Berndl ◽  
Kastriot Kastrati ◽  
Sandra Raab ◽  
...  
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Opioid Analgesics ◽  
Tension Type Headache ◽  
P Value ◽  
Cumulative Number ◽  
Number Of Patients ◽  
Withdrawal Therapy ◽  
Type Headache ◽  
Over Time

Background Definitions of medication overuse headache have changed over time. Objective To evaluate the clinical characteristics of medication overuse headache patients admitted for inpatient withdrawal therapy over a period of 32 years. Methods We included all patients with medication overuse headache treated from 1 January 1984 to 31 December 2015. We obtained all data from the medical reports and defined three periods, P1 (1984–1993), P2 (1994–2003), and P3 (2004–2015). The p-value adjusted for multiple comparisons was set to 0.005. Results Within 32 years, a total of 787 patients accounted for 904 admissions for MOH. From P1 to P3, the proportion of patients with preexisting migraine increased from 44.3% to 53.3% (chi2 = 9.0, p = 0.01) and that with preexisting tension-type headache decreased from 47.9% to 34.6% (chi2 = 9.3, p < 0.01). The median time since onset of headache and medication overuse headache decreased from 20 to 15 years ( p < 0.001) and from 3 to 2 years ( p < 0.001). The median cumulative number of single doses decreased from 120 to 90 per month ( p = 0.002). Overuse of triptans, non-opioid analgesics, and opioids increased, whereas overuse of ergotamines decreased over time ( p < 0.001 for all tests). The use of prophylactic medication before admission increased from 8.3% to 29.9% (chi2 = 89.5, p < 0.001). Conclusion This retrospective study in a large number of patients with medication overuse headache admitted for inpatient withdrawal therapy over a period of 32 years shows a trend towards changes in the preexisting headache type, a decrease in the time since onset of headache and medication overuse headache, a decrease in the number of drug doses used per month, changes in the type of drugs overused, and an increase in, but still low rate, of prophylactic medication prior to admission.

Tension Type Headache

2020 ◽  
pp. 318-358 ◽  
Author(s):  
Rohit Rastogi ◽  
Devendra Kumar Chaturvedi ◽  
Mayank Gupta
Keyword(s):  
Quality Of Life ◽  
Internet Of Things ◽  
Daily Life ◽  
Research Work ◽  
Tension Type Headache ◽  
Common Type ◽  
Fast Pace ◽  
Type Headache ◽  
Environment Stress

Development in the field of technology is growing with a fast pace, mainly the IoT (internet of things). It is an interface between machine-to-machine, machine-to-human, machine-to-infrastructure as well as machine-to-environment. Stress, especially TTH (tension type headache), is a serious problem in today's world. Now every person in this world is facing headache and stress-related problems in daily life. To measure the stress level, the authors have introduced the concept of EEG, EMG, and GSR biofeedback. In case of TTH, human is in a state in which one experiences pain like a physical weight or a tight band around one's head. TTH is different from migraine as it can be affected due to everyday activities. The most common type of primitive headache is tension type headache (TTH). The focus of the research work was to compare the impression of EMG-, GSR-, and EEG-integrated biofeedback on stress due to headache and quality of life of the subjects under consideration.

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