scholarly journals Fájdalomcsillapító-túlhasználathoz társuló fejfájás

2015 ◽  
Vol 156 (30) ◽  
pp. 1195-1202
Author(s):  
Máté Magyar ◽  
Boglárka Hajnal ◽  
Tamás Gyüre ◽  
Csaba Ertsey
Keyword(s):  
Risk Factors ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Headache Frequency ◽  
Depression And Anxiety ◽  
Preventative Therapy ◽  
Anticipatory Anxiety ◽  
Rebound Headache ◽  
Behavioural Factors

Medication-overuse headache affects 1 to 2 percent of the population. Any kind of painkiller, if taken regularly at least 10 days per month can cause medication-overuse headache, and therefore the possibility of this headache has to be raised whenever a patient with a preexistent headache notices a significant increase in headache frequency during a period of frequent painkiller consumption. Medication-overuse headache is most prevalent in females between 40 and 50 years of age. Its main risk factors are smokig, obesity, depression, and anxiety. The pathomechanism of medication-overuse headache is complex, with a probable genetic propensity and other biological (neurochemical and neurophysiological), as well as psychological and behavioural factors (such as anticipatory anxiety, catastrophisation of pain and consequentially a compulsive painkiller use) contributing to its genesis. The prerequisite of successful treatment is the withdrawal of the overused substance, other necessary elements of the therapy include the treatment of withdrawal symptoms including rebound headache, the introduction of an effective preventative therapy, taking into consideration the highly prevalent comorbid disorders as well, and the education and psychological support of patients. As the relapse rate can be as high as 30 to 40% regardless of effective treatment, the prevention of medication-overuse headache is of paramount importance, and the role of general practitioners can hardly be overstated. Orv. Hetil., 2015, 156(30), 1195–1202.

scholarly journals Psychopathological Comorbidities and Clinical Variables in Patients With Medication Overuse Headache

2020 ◽  
Vol 14 ◽  
Author(s):  
Simone Migliore ◽  
Matteo Paolucci ◽  
Livia Quintiliani ◽  
Claudia Altamura ◽  
Sabrina Maffi ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Drug Consumption ◽  
High Rate ◽  
Headache Frequency ◽  
Depression And Anxiety ◽  
Difficulties In Emotion Regulation ◽  
Control Study ◽  
Tas 20

The psychopathological profile of patients with medication overuse headache (MOH) appears to be particularly complex. To better define it, we evaluated their performance on a targeted psychological profile assessment. We designed a case-control study comparing MOH patients and matched healthy controls (HC). Headache frequency, drug consumption, HIT-6, and MIDAS scores were recorded. All participants filled in the following questionnaires: Beck Depression Inventory-II Edition (BDI-2), trait subtest of State-Trait Anxiety Inventory (STAI-Y), Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale (BIS-11), Toronto Alexithymia Scale (TAS-20). The primary endpoint was to establish if MOH patients have an altered psychopathological profile. The secondary endpoint was to establish whether the worst profile correlates with the worsening of headache and disability measures. We enrolled 48 consecutive MOH patients and 48 HC. MOH patients showed greater difficulty in recognition/regulation of emotions (DERS, TAS-20), depression (BDI-2), anxiety (STAI-Y), and impulsiveness (BIS-11). We found a positive correlation among DERS, BDI-2, STAI-Y, and BIS scores and MIDAS and HIT-6 scores and among DERS and headache frequency and drug consumption. MOH patients showed a high rate of emotion regulation difficulties, depression, and anxiety, which may negatively affect their headaches. The ability to regulate/recognize emotions may play a central role in sustaining medication overuse.

Analysis on the risk factors of medication-overuse headache in Chinese patients

2018 ◽  
Vol 48 ◽  
pp. 153-159
Author(s):  
Junxia Li ◽  
Chunfu Chen ◽  
Ligong Zhang ◽  
Xiaochen Cui ◽  
Chuanqiao Wei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Chinese Patients

Discontinuation of Medication Overuse in Headache Patients: Recovery of Therapeutic Responsiveness

Cephalalgia ◽  
2006 ◽  
Vol 26 (10) ◽  
pp. 1192-1198 ◽  
Author(s):  
P Zeeberg ◽  
J Olesen ◽  
R Jensen
Keyword(s):  
Drug Withdrawal ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Headache Frequency ◽  
Female Ratio ◽  
Headache Centre ◽  
Before And After ◽  
Male Female Ratio ◽  
Few Data ◽  
Almost All

It is generally accepted that ongoing medication overuse nullifies the effect of prophylactic treatment, although few data support this contention. We set out to describe the treatment outcome in patients withdrawn from medication overuse and relate any improvement to a renewed effect of prophylaxis. For patients with probable medication-overuse headache (pMOH), treated and dismissed from the Danish Headache Centre in 2002 and 2003, we assed, from prospective headache diaries, the headache frequency before and after withdrawal of offending drugs and compared these frequencies with the headache frequency at dismissal. Among 1326 patients, 337 had pMOH. Eligible were 175, mean age 49 years, male/female ratio 1: 2.7. Overall, there was a 46% decrease in headache frequency from the first visit to dismissal ( P < 0.0001). Patients with no improvement 2 months after complete drug withdrawal ( N = 88) subsequently responded to pharmacological and/or non-pharmacological prophylaxis with a 26% decrease in headache frequency as measured from the end of withdrawal to dismissal ( P < 0.0001). At dismissal, 47% were on prophylaxis. Former non-responders to medical prophylaxis had a 49% decrease in headache frequency from first visit to dismissal ( P < 0.0001), whereas those who had never received prophylaxis had a 56% reduction ( P < 0.0001). This difference was not statistically significant ( P = 0.22). Almost all MOH patients benefit from drug withdrawal, either just from the withdrawal or by transformation from therapeutic non-responsiveness to responsiveness. According to the International Classification of Headache Disorders, 2nd edn, the MOH diagnosis requires improvement after drug withdrawal. Our data suggest that these diagnostic criteria are too strict.

scholarly journals Associations of immunometabolic risk factors with symptoms of depression and anxiety: The role of cardiac vagal activity

2018 ◽  
Vol 73 ◽  
pp. 493-503 ◽  
Author(s):  
Mandy X. Hu ◽  
Brenda W.J.H. Penninx ◽  
Eco J.C. de Geus ◽  
Femke Lamers ◽  
Dora C.-H. Kuan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vagal Activity ◽  
Depression And Anxiety ◽  
Symptoms Of Depression

Risk factors in medication overuse headache: A one-year follow-up study

2010 ◽  
pp. 68-72 ◽  
Author(s):  
Natascia Ghiotto ◽  
Grazia Sances ◽  
Federica Galli ◽  
Cristina Tassorelli ◽  
Elena Guaschino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Follow Up Study ◽  
One Year

Involvement of Corticotrophin-Releasing Factor and Orexin-A in Chronic Migraine and Medication-Overuse Headache: Findings From Cerebrospinal Fluid

Cephalalgia ◽  
2008 ◽  
Vol 28 (7) ◽  
pp. 714-722 ◽  
Author(s):  
P Sarchielli ◽  
I Rainero ◽  
F Coppola ◽  
C Rossi ◽  
ML Mancini ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Potential Role ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Orexin A ◽  
Compensatory Response ◽  
Corticotrophin Releasing Factor ◽  
Response To Stress ◽  
The Brain

The study set out to investigate the role of corticotrophin-releasing factor (CRF) and orexin-A in chronic migraine (CM) and medication-overuse headache (MOH). Twenty-seven patients affected by CM and 30 with MOH were enrolled. Control CSF specimens were obtained from 20 age-matched subjects who underwent lumbar puncture for diagnostic purposes, and in all of them CSF and blood tests excluded central nervous system or systemic diseases. Orexin-A and CRF were determined by radioimmunoassay methods. Significantly higher levels of orexin-A and CRF were found in the CSF of MOH and to a lesser extent in patients with CM compared with control subjects (orexin-A: P < 0.001 and P < 0.02; CRF: P < 0.002 and P < 0.0003). A significant positive correlation was also found between CSF orexin-A values and those of CRF ( R = 0.71; P < 0.0008), monthly drug intake group ( R = 0.39; P < 0.03) and scores of a self-completion 10-item instrument to measure dependence upon a variety of substances, the Leeds Dependence Questionnaire (LDQ) in the MOH group ( R = 0.68; P < 0.0003). The significantly higher orexin-A levels found in CM and MOH can be interpreted as a compensatory response to chronic head pain or, alternatively, as an expression of hypothalamic response to stress due to chronic pain. A potential role for orexin-A in driving drug seeking in MOH patients through activation of stress pathways in the brain can also be hypothesized.

Psychiatric Comorbidity in the Evolution From Migraine to Medication Overuse Headache

Cephalalgia ◽  
2005 ◽  
Vol 25 (7) ◽  
pp. 519-522 ◽  
Author(s):  
F Radat ◽  
C Creac'h ◽  
JD Swendsen ◽  
M Lafittau ◽  
S Irachabal ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Odds Ratio ◽  
Psychiatric Comorbidity ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Anxiety And Depression ◽  
Psychoactive Substances ◽  
Addictive Disorders ◽  
Substance Related Disorders

We set out to study the role of psychiatric comorbidity in the evolution of migraine to medication overuse headache (MOH) by a comparative study of 41 migraineurs (MIG) and 41 patients suffering from MOH deriving from migraine. There was an excess risk of suffering from mood disorders [odds ratio (OR) = 4.5, 95% confidence interval (CI) 1.5, 13.5], anxiety (OR = 5, 95% CI 1.2, 10.7) and disorders associated with the use of psychoactive substances other than analgesics (OR = 7.6, 95% CI 2.2, 26.0) in MOH compared with MIG. Retrospective study of the order of occurrence of disorders showed that in the MOH group, psychiatric disorders occurred significantly more often before the transformation from migraine into MOH than after. There was no crossed-family transmission between MOH and psychiatric disorders, except for substance-related disorders. MOH patients have a greater risk of suffering from anxiety and depression, and these disorders may be a risk factor for the evolution of migraine into MOH. Moreover, MOH patients have a greater risk of suffering from substance-related disorders than MIG sufferers. This could be due to the fact that MOH is part of the spectrum of addictive disorders.

scholarly journals Melatonin Level Variations with Different Behavioural Risk Factors in Obese Female Patients

2017 ◽  
Vol 5 (5) ◽  
pp. 613-617 ◽  
Author(s):  
Ana Malazonia ◽  
Tamar Zerekidze ◽  
Elen Giorgadze ◽  
Natia Chkheidze ◽  
Ketevan Asatiani
Keyword(s):  
Risk Factors ◽  
The Body ◽  
Control Group ◽  
Melatonin Level ◽  
Study Group ◽  
Female Patients ◽  
Behavioural Risk Factors ◽  
Obese Female ◽  
Behavioural Factors

AIM: The role of behavioural factors and sleep duration and quality is important in the pathogenesis of obesity. The aim of our study was to evaluate the effects of behavioural risk factors on melatonin secretion in women.SUBJECTS AND METHODS: In total, 120 female patients were enrolled in the study and divided into two groups according to the body mass index. Detailed history, anthropometric measurements, urine and blood samples were evaluated for each patient.RESULTS: Two groups significantly differed in weight, BMI, and waist circumference, and were 94.2 ± 14.9 kg, 33.4 ± 5.23 kg/m2 and 99.2 ± 12.6 cm for the study group and 56.0 ± 5.2 kg, 20.0 ± 1.8 kg/m2 and 60.1 ± 10.4 cm for the control group, respectively, sleep disruptions were detected in 48 patients from study group, with mean score 6.76 ± 3.6, and only 10 patients were detected in the control group, with mean score 4.42 ± 1.68. Eating disturbances were revealed in 66 patients from the study group and 21 patients from the control group. Melatonin levels were 17% higher in the study group, compared to control group.CONCLUSION: Higher melatonin levels in patients with obesity and concomitant behavioural impairments may be due to its protective effect to fight free radicals and to induce vasodilatation. Further studies are needed to confirm our finding.

Difficult to Treat (Refractory) Chronic Migraine: Outpatient Approaches

2020 ◽  
Author(s):  
Lawrence Robbins
Keyword(s):  
Medication Overuse ◽  
Trigger Point ◽  
Medication Overuse Headache ◽  
Key Words Headache ◽  
Refractory Chronic Migraine ◽  
Refractory Migraine ◽  
The Many ◽  
Long Acting ◽  
Intravenous Ketamine

This comprehensive review addresses the many challenges in treating refractory migraine. Issues relating to pathophysiology are covered. A unique “refractory scale for migraine patients” is introduced. The definition and role of medication overuse headache are presented with a much different perspective than is usually found. Issues outside of medication that are covered include active coping, acceptance, resilience, and catastrophizing. A number of outpatient treatments are thoroughly discussed. These include the role of onabotulinum toxin, the application of polypharmacy, when to employ sphenopalatine ganglion  blocks, the role of occipital and trigger-point injections, the implementation of long-acting opioids, the advantages of stimulants, and the possible use of monoamine oxidase inhibitors. Miscellaneous approaches include muscle relaxants, nasal or intravenous ketamine, transcranial magnetic stimulation, memantine, and ergonovine. Finally, many cutting-edge “refractory clinical pearls” are listed.  This review contains 8 highly rendered figures, 4 tables, and 25 references. Key Words: Headache, migraine, chronic, refractory, medication overuse, alternative, treatments

Risk factors in medication-overuse headache: A 1-year follow-up study (care II protocol)

Cephalalgia ◽  
2009 ◽  
Vol 30 (3) ◽  
pp. 329-336 ◽  
Author(s):  
G Sances ◽  
N Ghiotto ◽  
F Galli ◽  
E Guaschino ◽  
C Rezzani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Treatment Strategies ◽  
Primary Headache ◽  
Headache Centre ◽  
Chi Squared ◽  
One Year ◽  
Predictor Factors

To investigate factors influencing prognosis in medication-overuse headache (MOH), we conducted a 12-month follow-up of patients with probable MOH. We recruited 215 patients consecutively admitted to our headache centre for an inpatient detoxification treatment. We analysed likely predictor factors for headache resolution (sex, age, primary headache, psychiatric comorbidity, type and timing of overuse). Mann–Whitney U-test and chi-squared test were used. One year after withdrawal, we had complete data on 172 patients (80%): 38 of these patients (22%) had relapsed into overuse and 134 (78%) had not. The negative prognostic factors for relapse were: intake of more than 30 doses/month ( P = 0.004), smoking ( P = 0.012), alcohol consumption ( P = 0.037), non-confirmation of MOH diagnosis 2 months after detoxification ( P = 0.000), and return to overused drug(s) ( P = 0.000). The 1-year relapse rate was 22%. The existence of sub-groups of MOH patients with such risk factors could influence treatment strategies.

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