Overuse of acute migraine medications and migraine chronification
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Among individuals with episodic migraine, the influence of excessive acute medication use on the development of chronic migraine depends upon within-person characteristics (eg, headache frequency), class of drug, and frequency of medication use. Available data suggest that opioids induce migraine chronification (progression), and the effect is dose dependent (critical dose around 8 days of exposure per month) and more pronounced in men. Barbiturates also induce migraine progression, and the effect is dose dependent (critical dose around 5 days of exposure per month) and more pronounced in women. Triptans induce migraine progression only in those with high migraine frequency at baseline (10–14 days per month), but not overall. NSAIDs protect against migraine progression unless individuals have 10 or more headache days per month (when they become inducers, rather than protective). Finally, caffeine-containing over-the-counter products increase risk of progression. While we await randomized trials, these findings should inform the choice of acute migraine treatments with the goal of reducing the risk of migraine progression to chronic migraine.
- Headache Classification Subcommittee of the International Headache Society: The International Classification of Headache Disorders, 2nd edn. Cephalalgia 2004, 24(Suppl 1):1–149.
- Bigal ME, Lipton RB: Excessive acute migraine medication use and migraine progression. Neurology 2008, 71:1821–1828. CrossRef
- Slone Epidemiology Center at Boston University: Annual Reports on Medication Use in the US. Available at http://www.bu.edu/slone/SloneSurvey/SloneSurvey.htm. Accessed January 2009.
- Gutzwiller F, Leu RE, Schulz HR, et al.: The Swiss Health Survey Project (SOMIPOPS): an example of a data collection effort from various sources. Soz Praventivmed 1985, 30:76–79. CrossRef
- Ballantyne JC, Mao J: Opioid therapy for chronic pain. N Engl J Med 2003, 349:1943–1953. CrossRef
- Sullivan LE, Chawarski M, O’Connor PG, et al.: The practice of office-based buprenorphine treatment of opioid dependence: is it associated with new patients entering into treatment? Drug Alcohol Depend 2005, 79:113–116. CrossRef
- Diamond S, Bigal ME, Silberstein S, et al.: Patterns of diagnosis and acute and preventive treatment for migraine in the United States: results from the American Migraine Prevalence and Prevention study. Headache 2007, 47:355–363.
- Haut SR, Bigal ME, Lipton RB: Chronic disorders with episodic manifestations: focus on epilepsy and migraine. Lancet Neurol 2006, 5:148–157. CrossRef
- Mathew NT, Reuveni U, Perez F: Transformed or evolutive migraine. Headache 1987, 27:102–106. CrossRef
- Bigal ME, Rapoport AM, Sheftell FD, et al.: Chronic migraine is an earlier stage of transformed migraine in adults. Neurology 2005, 65:1556–1561. CrossRef
- Bigal ME, Lipton RB: Modifiable risk factors for migraine progression. Headache 2006, 46:1334–1343. CrossRef
- Castillo J, Munoz P, Guitera V, Pascual J: Kaplan Award 1998. Epidemiology of chronic daily headache in the general population. Headache 1999, 39:190–196. CrossRef
- Scher AI, Stewart WF, Liberman J, Lipton RB: Prevalence of frequent headache in a population sample. Headache 1998, 38:497–506. CrossRef
- Compton WM, Volkow ND: Major increases in opioid analgesic abuse in the United States: concerns and strategies. Drug Alcohol Depend 2006, 81:103–107. CrossRef
- Katsarava Z, Schneeweiss S, Kurth T, et al.: Incidence and predictors for chronicity of headache in patients with episodic migraine. Neurology 2004, 62:788–790.
- Wilkinson SM, Becker WJ, Heine JA: Opiate use to control bowel motility may induce chronic daily headache in patients with migraine. Headache 2001, 41:303–309. CrossRef
- Bahra A, Walsh M, Menon S, Goadsby PJ: Does chronic daily headache arise de novo in association with regular use of analgesics? Headache 2003, 43:179–190. CrossRef
- Paemeleire K, Bahra A, Evers S, et al.: Medication-overuse headache in patients with cluster headache. Neurology 2006, 67:109–113. CrossRef
- Williams L, O’Connell K, Tubridy N: Headaches in a rheumatology clinic: when one pain leads to another. Eur J Neurol 2008, 15:274–277. CrossRef
- Bigal ME, Lipton RB: Clinical course in migraine: conceptualizing migraine transformation. Neurology 2008, 71:848–855. CrossRef
- Lipton RB, Bigal ME, Diamond M, et al.: Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 2007, 68:343–349. CrossRef
- Bigal ME, Serrano D, Lipton RB: The acute treatment of episodic and chronic migraine in the United States. Cephalalgia 2009 (in press).
- Scher AI, Stewart WF, Bigal ME: Patterns of medical consultation and medication use by chronic and episodic headache sufferers in the general population: results from the Frequent Headache Epidemiology Study. Neurology 2009 (in press).
- Zwart JA, Dyb G, Hagen K, et al.: Analgesic use: a predictor of chronic pain and medication overuse headache: the Head-HUNT Study. Neurology 2003, 61:160–164.
- Bigal ME, Serrano D, Buse D, et al.: Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population-based study. Headache 2008, 48:1157–1168. CrossRef
- Himsworth H: Bradford Hill and statistics in medicine. Stat Med 1982, 1:301–303. CrossRef
- King T, Ossipov MH, Vanderah TW, et al.: Is paradoxical pain induced by sustained opioid exposure an underlying mechanism of opioid antinociceptive tolerance? Neurosignals 2005, 14:194–205. CrossRef
- Yamamoto T, Nair P, Vagner J, et al.: A structure-activity relationship study and combinatorial synthetic approach of C-terminal modified bifunctional peptides that are delta/mu opioid receptor agonists and neurokinin 1 receptor antagonists. J Med Chem 2008, 51:1369–1376. CrossRef
- Zeeberg P, Olesen J, Jensen R: Discontinuation of medication overuse in headache patients: recovery of therapeutic responsiveness. Cephalalgia 2006, 26:1192–1198. CrossRef
- Bigal ME, Sheftell FD, Tepper SJ, Rapoport AM: Discontinuation of medication overuse in headache patients: recovery of therapeutic responsiveness. Cephalalgia 2007, 27:568; author reply 568–569. CrossRef
- Overuse of acute migraine medications and migraine chronification
Current Pain and Headache Reports
Volume 13, Issue 4 , pp 301-307
- Cover Date
- Print ISSN
- Online ISSN
- Current Science Inc.
- Additional Links