Internal and Emergency Medicine

, Volume 5, Supplement 1, pp 7–11 | Cite as

Chronic headaches and medication overuse

  • Pierangelo Geppetti
  • Francesco De Cesaris
  • Paola Nicoletti
  • Silvia Benemei
Symposium: Chronicisation of Headaches. Natural Evolution, Drugs Dependence and Rehabilitation
First Online:

Abstract

Chronic headaches represent a significant burden for the affected individuals and for the society, and a major challenge for successful care. Among the various types of chronic headaches, those that are associated with medication overuse (medication-overuse headache, MOH) are of particular importance because of the large proportion of patients who complain of this condition and their poor outcome. Most patients with MOH had migraine as primary headache. Practically, almost all drugs used for the symptomatic relief of migraine, including triptans and analgesics can cause MOH. Although the pathophysiology of MOH is unknown, recent studies hypothesize that plastic changes in specific pain areas of the central nervous system are main contributors to establishing MOH. Not infrequently, drug overuse is associated with habituation and failure of previously effective medications. Finally, treatment of MOH is poorly evidence based and mostly relies on clinical experience and belief.

Keywords

Medication-overuse headache Anti-migraine drugs Chronification 
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Notes

Acknowledgments

The paper has been supported in part by grants by Consorzio Ferrara Ricerche.

Conflict of interest

None.

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Copyright information

© SIMI 2010

Authors and Affiliations

  • Pierangelo Geppetti
    • 1
    • 2
  • Francesco De Cesaris
    • 1
    • 2
  • Paola Nicoletti
    • 1
    • 2
  • Silvia Benemei
    • 1
    • 2
  1. 1.Headache Center, Careggi University HospitalUniversity of FlorenceFlorenceItaly
  2. 2.Department of Preclinical and Clinical PharmacologyUniversity of FlorenceFlorenceItaly

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