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Headache with medication overuse: treatment strategies and proposals of relapse prevention

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Abstract

The diagnosis of medication overuse headache (MOH) is clinically important, because patients rarely respond to preventive medications whilst overusing acute medications. Properly treating medication overuse and preventing relapse require recognition of the different factors that contribute to its development and perpetuation, including some behaviours and psychological elements that are important in sustaining the overuse of medication. This article reviews current clinical experiences of MOH patients treated with different approaches. Moreover, initial outcomes and long-term durability of treatments are discussed.

Sommario

La diagnosi di Medication-Overuse Headache è impegnativa e presenta implicazioni clinico-terapeutiche importanti poiché questa categoria di pazienti difficilmente risponde alle terapie di profilassi comunemente usate nei pazienti emicranici. Un trattamento adeguato ed una attenta prevenzione delle recidive di abuso richiedono una valutazione dei diversi fattori di rischio che contribuiscono allo sviluppo e alla degenerazione delle forme emicraniche episodiche in forme croniche. Anche i fattori psicologici e comportamentali sono riconosciuti come determinanti per la induzione del “Medication-Overuse”. In questo lavoro vengono descritte diverse esperienze cliniche condotte in pazienti affette da forme emicraniche cronicizzate e Medication-Overuse; sono descritti i diversi approcci terapeutici e le possibili strategie terapeutiche a partire dalla “disassuefazione” da sintomatici alla impostazione di una eventuale profilassi. Sono inoltre menzionati e discussi i risultati derivanti dalle diverse esperienze cliniche con relativi follow-up.

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Authors and Affiliations

  1. Headaches and Cerebrovascular Disorders Unit, C. Besta National Neurological Institute, Via Celoria 11, 20133, Milan, Italy

    Licia Grazzi, Susanna Usai & Gennaro Bussone

  2. Department of Psychology, University of West Florida, Pensacola, FL, USA

    Frank Andrasik

Authors
  1. Licia Grazzi
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  2. Frank Andrasik
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  3. Susanna Usai
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  4. Gennaro Bussone
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Correspondence to Licia Grazzi.

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Grazzi, L., Andrasik, F., Usai, S. et al. Headache with medication overuse: treatment strategies and proposals of relapse prevention. Neurol Sci 29, 93–98 (2008). https://doi.org/10.1007/s10072-008-0867-8

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  • DOI: https://doi.org/10.1007/s10072-008-0867-8

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