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What future for treatment of chronic migraine with medication overuse?

  • Licia GrazziEmail author
  • G. Bussone
ANIRCEF - HCNE Joint Meeting

Abstract

Chronic headaches have increasingly become a focus within the field of head pain. Most of the patients with frequent headache eventually overuse their medications, and if it happens [the percentage is approximately 4%], the diagnosis of chronic migraine with medication-overuse headache is clinically important, because patients rarely respond to preventive medications while overusing acute medications. This kind of headache is recognized as a biobehavioral disorder, a complex condition wherein emotion and pain are intermingled. Properly treating medication overuse with adequate strategies by different and specific steps are essential components for helping these patients to improve and for preventing relapses. The clinical experience performed at our Headache Unit, the necessity of withdrawal, different treatment schedules, and different treatment strategies of our center were discussed.

Keywords

Chronic headache Medication Withdrawal protocols Strategies of treatment 

Notes

Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.

References

  1. 1.
    Diener HC, Limmroth V (2004) Medication-overuse headache: a worldwide problem. Lancet Neurol 3:475–483PubMedCrossRefGoogle Scholar
  2. 2.
    Meskunas CA, Tepper SJ, Rapoport AM, Sheftell FD, Bigal ME (2006) Medications associated with probable medication overuse headache reported in a tertiary care headache center over a 15-year period. Headache 46:766–772PubMedCrossRefGoogle Scholar
  3. 3.
    Grazzi L, Andrasik F, Usai S, Bussone G (2009) Treatment of chronic migraine with medication overuse: is drug withdrawal crucial? Neurol Sci 30(S1):85–88CrossRefGoogle Scholar
  4. 4.
    Andrasik F, Grazzi l, Usai S, Buse DC, Bussone G (2009) Non-pharmacological approaches to treating crhonic migraine with medication overuse. Neurol Sci 30(S1):89–94CrossRefGoogle Scholar
  5. 5.
    Grazzi F, Andrasik F, Usai S, Bussone G (2008) Headache with medication overuse: treatment strategies and proposal of relapse prevention. Neurol Sci 29:93–98PubMedCrossRefGoogle Scholar
  6. 6.
    Saper JR, Hamel RL, Lake AE III (2005) Medication overuse headache (MOH) is a biobehavioural disorder. Cephalalgia 25:545–546PubMedCrossRefGoogle Scholar
  7. 7.
    Lake AE III (2006) Medication overuse headache: biobehavioral issues and solutions. Headache 46(Suppl 3):S88–S97PubMedCrossRefGoogle Scholar
  8. 8.
    Grazzi L, Andrasik F, D’Amico D, Leone M, Usai S, Kass S, Bussone G (2002) Behavioral and pharmacologic treatment of transformed migraine with analgesic overuse: outcome at 3 years. Headache 42:483–490PubMedCrossRefGoogle Scholar
  9. 9.
    Bigal ME, Lipton RB (2006) Modifiable risk factors for migraine progression. Headache 46:1334–1343PubMedCrossRefGoogle Scholar
  10. 10.
    Montagna P, Pierangeli G, Cortelli P (2009) The primary headaches as a reflection of genetic darwinian adaptive behavioral responses. Headache 50:273–289PubMedCrossRefGoogle Scholar
  11. 11.
    Calabresi P, Cupini ML (2005) Medication-overuse headache: similarities with drug addiction. Trends Pharmacol Sci 28(2):62–68CrossRefGoogle Scholar
  12. 12.
    Grazzi L, Chiapparini L, Ferraro S, Usai S, Andrasik F, Mandelli ML, Bruzzone MG, Bussone G (2010) Chronic migraine with medication overuse pre-post withdrawal of symptomatic medication: clinical results and FMRI correlations. Headache 50:998–1004PubMedCrossRefGoogle Scholar
  13. 13.
    Rothrock JF, Parada VA, Sims C et al (2006) The impact of intensive patient education on clinical outcome in a clinic-based migraine population. Headache 46:726–731PubMedCrossRefGoogle Scholar
  14. 14.
    Dodick D, Silberstein S (2008) How clinicians can detect, prevent, and treat medication overuse headache. Cephalalagia 28(11):1207–1217CrossRefGoogle Scholar
  15. 15.
    Aurora S, Dodick D, Turkel C et al (2010) Onabotulinum A for treatment of chronic migraine : Results from the double blind, randomized, placebo-controlled phase of the PREEMPT 1 trial. Cephalalgia 40(7):793–803CrossRefGoogle Scholar
  16. 16.
    Diener HC, Dodick D, Aurora S (2010) Onabotulinum A for treatment of chronic migarine: pooled results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 2 trial. Cephalalagia 30(7):804–814CrossRefGoogle Scholar
  17. 17.
    Rains JC, Penzien DB, Lipchik GL (2006) Behavioral facilitation of medical treatment for headache–Part II: Theoretical models and behavioral strategies for improving adherence. Headache 46:1395–1403PubMedCrossRefGoogle Scholar
  18. 18.
    Jensen MP (2002) Enhancing motivations to change in pain treatment. In: Turk DC, Gatchel RJ (eds) Psychological approaches to pain management: a practitioner’s handbook, 2nd edn. Guilford Press, New York, pp 71–93Google Scholar
  19. 19.
    Miller WR (1996) Motivational interviewing: research, practice, and puzzles. Addict Behav 21:835–842PubMedCrossRefGoogle Scholar
  20. 20.
    Andrasik F (2007) What does the evidence show? Efficacy of behavioural treatments for recurrent headaches in adults. Neurol Sci 28:S70–S77PubMedCrossRefGoogle Scholar
  21. 21.
    Nestoriuc Y, Martin A, Rief W, Andrasik F (2008) Biofeedback treatment for headache disorders: a comprehensive efficacy review. Appl Psychophysiol Biofeedback 33:125–140PubMedCrossRefGoogle Scholar
  22. 22.
    Jette N, Patten S, Williams J et al (2008) Comorbidity of migraine and psychiatric disorders: a national population-based study. Headache 48:501–516PubMedCrossRefGoogle Scholar
  23. 23.
    Smitherman TA, Maizels M, Penzien DB (2008) Headache chronification: Screening and behavioral management of comorbid depressive and anxiety disorders. Headache 48:45–50PubMedCrossRefGoogle Scholar
  24. 24.
    Lipchik GL, Smitherman TA, Penzien DB, Holroyd KA (2006) Basic principles and techniques of cognitive-behavioral therapies for comorbid psychiatric symptoms among headache patients. Headache 46(Suppl 3):S119–S132PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Neurological Sciences, Headache UnitNeurological Institute “C.Besta” IRCCS FoundationMilanItaly
  2. 2.Department of Neurological Sciences, Headache UnitNeurological Institute “C.Besta” IRCCS FoundationMilanItaly

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