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Topic: Medication overuse headache in CH (Read 211 times) |
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Bob_Johnson
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Medication overuse headache in CH
« on: Jul 18th, 2006, 11:37am » |
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Neurology. 2006 Jul 11;67(1):109-13.
Medication-overuse headache in patients with cluster headache.
Paemeleire K, Bahra A, Evers S, Matharu MS, Goadsby PJ.
Headache Group, Institute of Neurology, Queen Square, London, UK.
OBJECTIVE: Medication-overuse headache (MOH) in cluster headache (CH) patients is incompletely described, perhaps because of the relatively low prevalence of CH. METHODS: The authors describe a retrospective series of 17 patients (13 men, 4 women) with CH who developed MOH in association with overuse of a wide range of monotherapies or varying combinations of simple analgesics (n = 9), caffeine (n = 1), opioids (n = 10), ergotamine (n = 3), and triptans (n = 14). The series includes both episodic (n = 7) and chronic (n = 10) CH patients. RESULTS: A specific triptan-overuse headache diagnosis was made in 3 patients, an opioid-overuse headache diagnosis was made in 1 patient, and an ergotamine-overuse headache diagnosis was made in 1 patient. In approximately half of the patients (n =  , the MOH phenotype was a bilateral, dull, and featureless daily headache. In the other 9 patients, the MOH was characterized by at least one associated feature, most commonly nausea (n = 6), exacerbation with head movement (n = 5), or throbbing character of the pain (n = 5). The common denominator in 15 patients was a personal or family history, or both, of migraine. The 2 other patients gave a family history of unspecified headaches. Medication withdrawal was attempted and successful in 13 patients. CONCLUSIONS: Medication-overuse headache is a previously underrecognized and treatable problem associated with cluster headache (CH). CH patients should be carefully monitored, especially those with a personal or family history of migraine.
PMID: 16832088
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Bob Johnson
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Charlotte
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Re: Medication overuse headache in CH
« Reply #1 on: Jul 18th, 2006, 3:36pm » |
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I think medicine overuse can be a real problem because of the number of headaches we get. Not only overuse, but using the wrong medication.
Also, at different stages, different medications seem to work or not work. There is no formula.
Charlotte
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Bob_Johnson
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Re: Medication overuse headache in CH
« Reply #2 on: Jul 18th, 2006, 4:29pm » |
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Unfortunately, this is a well established diagnosis associated with pain aborting medications. The exact dosing which may lead to it is unknown--varies with the individual--but it's a condition which we need to keep in mind.
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Bob Johnson
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BarbaraD
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Re: Medication overuse headache in CH
« Reply #3 on: Jul 18th, 2006, 5:32pm » |
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We've been warning newbies about this for years.
The part about a family history of migraines is interesting. My family has a history of them, but I got the CH (now have developed arthritic migraines).
But the caffeine part got me. I guess I just never get off it long enough to have withdrawal. I don't think anyone would want to see me off it.
Hugs BD
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