Neurológia pre prax 1/2012

Mediaction overuse headache

Medication overuse headache belongs to the group of chronic daily headache (CDH). When some of the serious secondary headaches, such as brain tumour, cerebrovascular disease or other diseases caused by a structural lesion of the central nervous system, are ruled out, in typical migraine sufferers CDH may develop by transformation from episodic to chronic migraine, or it may be primary chronic tension- type headache, and/or the headache may result from overuse of medications (medication overuse headache, MOH). In the latter case, there is primarily an interaction between an excessively used acute analgesic drug and a predisposed type of patient. It has been shown that frequent and regular use of analgesic-antipyretic drugs, nonsteroidal anti-inflammatory drugs (NSAIDs), ergotamine agents, triptans, opioids or combinations of these drugs may result in drug-induced headache, and not in pain relief. This condition can be managed by withdrawal of the overused medication, detoxification, and initiation of both adequate prophylaxis and appropriate acute treatment. Successful treatment requires the patient’s motivation and the physician’s persistent supervision and feedback. The article presents the opinion of an expert who deals with this problem in the practice and describes experience from the author’s workplace.

Keywords: medication overuse headache, classification, pain chronification, analgesics, nonsteroidal anti-inflammatory drugs, triptans, ergotamine, treatment.