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.

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.

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.

Mattering and Anti-Mattering in Emotion Regulation and Life Satisfaction: A Mediational Analysis of Stress and Distress During the COVID-19 Pandemic

2021 ◽  
pp. 073428292110567
Author(s):  
Barbara Giangrasso ◽  
Silvia Casale ◽  
Giulia Fioravanti ◽  
Gordon L. Flett ◽  
Taryn Nepon
Keyword(s):  
Life Satisfaction ◽  
Emotion Regulation ◽  
Reliability And Validity ◽  
Self Esteem ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Structure Reliability ◽  
Global Pandemic ◽  
Difficulties In Emotion Regulation ◽  
Lower Life Satisfaction

The current study focused primarily on the associations that feelings of not mattering have with life satisfaction, stress, and distress among students trying to cope with the uncertain and novel circumstances brought about by the COVID-19 pandemic. A sample of 350 University students from Italy completed measures that included the General Mattering Scale and the Anti-Mattering Scale, as well as measures of self-esteem, difficulties in emotion regulation, life satisfaction, perceived stress, anxiety, and depression. Psychometric analyses confirmed the factor structure, reliability, and validity of the General Mattering Scale and the Anti-Mattering Scale. As expected, feelings of not mattering were associated with lower life satisfaction as well as with greater reported difficulties in emotion regulation, stress, and distress. Mattering and self-esteem were both unique predictors of levels of life satisfaction during the pandemic. The results of mediational analyses suggested that individuals who feel as though they do not matter may be especially vulnerable to stress, depression, and anxiety and this may promote a decline in life satisfaction. Given the potential destructiveness of feelings of not mattering, in general but especially during a global pandemic, it is essential to proactively develop interventions and programs that are designed to enhance feelings of mattering and reduce anti-mattering experiences and feelings.

Chronic Migraine and Medication-Overuse Headache Through the Ages

Cephalalgia ◽  
2005 ◽  
Vol 25 (5) ◽  
pp. 378-390 ◽  
Author(s):  
CJ Boes ◽  
DJ Capobianco
Keyword(s):  
Chronic Migraine ◽  
English Language ◽  
Medication Overuse ◽  
International Headache Society ◽  
Medication Overuse Headache ◽  
Headache Frequency ◽  
Ihs Criteria ◽  
Acute Headache

We set out to review early descriptions of chronic migraine and medication-overuse headache. The International Headache Society (IHS) recently gave criteria for chronic migraine and medication-overuse headache. Chronic migraine was absent from the 1988 IHS criteria. Peters and Horton described ergotamine-overuse headache in 1951. In the 1980s it was more fully appreciated that overuse of other acute headache medications could increase headache frequency. We reviewed published English-language papers and book chapters. Willis (1672), Oppenheim (1900), Collier (1922), Balyeat (1933), and von Storch (1937) all described chronic migraine. Lennox (1934), O'Sullivan (1936), Silfverskiöld (1947), Graham (1955), Friedman (1955), and Lippman (1955) wrote about ergotamine-overuse headache. Graham (1955), Friedman (1955), Lippman (1955), and Horton and Peters (1963) outlined withdrawal protocols. Chronic migraine has been mentioned in the literature for centuries, while medication-overuse headache has been written about for decades. Graham, Friedman, and Lippman deserve credit for separately reporting the first ergotamine withdrawal programmes.

Medication overuse headache

Neurology ◽  
2017 ◽  
Vol 89 (12) ◽  
pp. 1296-1304 ◽  
Author(s):  
Ann I. Scher ◽  
Paul B. Rizzoli ◽  
Elizabeth W. Loder
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Secondary Headache ◽  
Headache Frequency ◽  
Drug Induced ◽  
Strong Basis ◽  
Medication Withdrawal ◽  
Symptomatic Medication ◽  
Treatment Limitation ◽  
Drug Induced Headache

It is a widely accepted idea that medications taken to relieve acute headache pain can paradoxically worsen headache if used too often. This type of secondary headache is referred to as medication overuse headache (MOH); previously used terms include rebound headache and drug-induced headache. In the absence of consensus about the duration of use, amount, and type of medication needed to cause MOH, the default position is conservative. A common recommendation is to limit treatment to no more than 10 or 15 days per month (depending on medication type) to prevent headache frequency progression. Medication withdrawal is often recommended as a first step in treatment of patients with very frequent headaches. Existing evidence, however, does not provide a strong basis for such causal claims about the relationship between medication use and frequent headache. Observational studies linking treatment patterns with headache frequency are by their nature confounded by indication. Medication withdrawal studies have mostly been uncontrolled and often have high dropout rates. Evaluation of this evidence suggests that only a minority of patients required to limit the use of symptomatic medication may benefit from treatment limitation. Similarly, only a minority of patients deemed to be overusing medications may benefit from withdrawal. These findings raise serious questions about the value of withholding or withdrawing symptom-relieving medications from people with frequent headaches solely to prevent or treat MOH. The benefits of doing so are smaller, and the harms larger, than currently recognized. The concept of MOH should be viewed with more skepticism. Until the evidence is better, we should avoid dogmatism about the use of symptomatic medication. Frequent use of symptom-relieving headache medications should be viewed more neutrally, as an indicator of poorly controlled headaches, and not invariably a cause.

scholarly journals Interrelation of Alexithymia and Affective and Personal Properties in Persons Dependent on Alcohol

2018 ◽  
pp. 36-41
Author(s):  
I. V. Grigorieva ◽  
M. M. Skugarevskaya ◽  
M. N. Trushchenko ◽  
T. A. Adamchuk
Keyword(s):  
Emotion Regulation ◽  
Alcohol Dependence ◽  
Negative Attitude ◽  
Medical Rehabilitation ◽  
High Rate ◽  
Difficulties In Emotion Regulation ◽  
Beck Hopelessness Scale ◽  
Alcohol Dependence Syndrome ◽  
Control Application ◽  
Alcohol Dependent

Objective: to define interrelation of alexithymia and affective and personal properties in persons dependent on alcohol. Material and methods. 41 patients with alcohol dependence syndrome were under observation. The method of complex medical rehabilitation was applied during work with patients with alcohol dependence syndrome and disturbance of mood. The following techniques were used: the Toronto Alexithymia Scale (TAS-20); the Hospital scale of anxiety and a depression (HADS); the Beck Hopelessness Scale; the Existence Scale by A. Längle; the Level of Subjective Control (LSC); the Scale of diagnostics of frustration of a bipolar range (BSDS). Results. Alexithymia in patients with alcohol dependence syndrome is directly interconnected with anxiety as per the Difficulties in Emotion Regulation Scale, with the Beck Hopelessness Scale (R = 0.55; p = 0.02), which shows growing self-dissociation in alcohol dependent persons, reveals interrelations of all the alexithymia scales with the subscales of the Existence Scale technique, indicates a direct link of the Beck Hopelessness Scale with the subscales of the Difficulties in Emotion Regulation Scale (R = 0.56; p = 0.022) and “externally focused thinking” (R = 0.57; p = 0.02). Thus, expressed negative attitude of dependent persons to their own future is directly connected with inability to identify their own feelings. Conclusion. Alcohol dependent persons reveal a high rate of alexithymia, which has interrelations with anxiety, depression, existential sensibleness, level of subjective control. Application of complex medical rehabilitation is effective in respect of decreasing the alexithymia rate and affective disorders, increasing consciousness and self-expression of feelings in persons dependent on alcohol.

A randomized trial of telephone-based motivational interviewing for adolescent chronic headache with medication overuse

Cephalalgia ◽  
2013 ◽  
Vol 34 (6) ◽  
pp. 446-454 ◽  
Author(s):  
Jack Stevens ◽  
John Hayes ◽  
Ann Pakalnis
Keyword(s):  
Motivational Interviewing ◽  
Medication Overuse ◽  
Controlled Trial ◽  
Medication Overuse Headache ◽  
Standard Of Care ◽  
Tension Type Headache ◽  
Headache Frequency ◽  
Care Clinic ◽  
Headache Severity ◽  
Phone Calls

Introduction Nearly 2% of youths suffer from chronic migraine or chronic tension-type headache (CTTH). A contributing factor in approximately 20%–50% of these youths is medication overuse, which involves taking analgesics three or more times per week for three months. The objective of this study was to test motivational interviewing (MI) as an approach to promote adherence to recommendations regarding not only analgesic overuse but also other aspects of treatment plans. Methods A randomized controlled trial was conducted comparing the experimental condition (standard of care clinic-based treatment with supplemental MI phone calls; n = 24) to a control condition (standard of care clinic-based treatment without these supplemental MI phone calls; n = 23). Four months after enrollment, a research assistant who was blinded to study condition telephoned adolescents inquiring about headache frequency, headache severity, and disability. Results Headache frequency was lower in the experimental condition versus control condition for those with relatively lower initial levels of headache frequency. In contrast, we did not find greater improvement in headache severity and disability for the experimental condition relative to the control condition. Discussion Our findings provided some preliminary, albeit limited, support for MI as an approach to improve outcomes for adolescent medication-overuse headache (MOH).

Detoxification in a structured programme is effective for medication-overuse headache

2012 ◽  
Vol 3 (3) ◽  
pp. 198
Author(s):  
Signe Bruun Munksgaard ◽  
Lars Bendtsen ◽  
Rigmor Højland Jensen
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Educational Programme ◽  
Headache Frequency ◽  
Treatment Resistant ◽  
Headache Centre ◽  
Symptomatic Medication ◽  
Multidisciplinary Education ◽  
One Year

AbstractAimTo evaluate the long-term efficacy of two different treatment programmes for medication-overuse headache (MOH) in so-called treatment-resistant patients.MethodsMOH patients, who had previously been unsuccessfully treated by neurologists, were enrolled in one of 2 structured detoxification programmes in a tertiary headache centre: (A) a one-week withdrawal with restricted analgesics, rescue medications and prophylactics from Day 1 followed by advice of restricted intake of symptomatic medications or (B) a 2-month drug-free period and multidisciplinary education in groups and subsequent initiation of restricted symptomatic medication and prophylactics as required. All patients were closely followed up for a year.Results86 of 98 patients completed the 12-month follow-up. Totally, headache frequency was reduced by 39% (p <0.001), medication use by 63% (p <0.001) and 83% remained cured of MOH. Headache frequency was reduced with more than 50% in 42 patients (49%) and 52 (61%) reverted to episodic headache, and with no difference between the groups. Patients in programme B used significantly less symptomatic medication: 6.5 days/4 weeks compared with 8.7 days/4 weeks in programme A (p = 0.02), and the 56% of patients in programme B who needed prophylactic medication was significantly less than the 80% in programme A (p = 0.02). Further, programme B required fewer resources from the staff.ConclusionStructured detoxification with close follow-up by a multidisciplinary team for one year is highly effective in patients with previously treatment-resistant MOH. We recommend a multidisciplinary educational programme for patients in groups due to cost-effectiveness and limited use of medication.

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