Is Medication Overuse Drug Specific or Not? Data from a Review of Published Literature and from an Original Study on Italian MOH Patients

Current Pain and Headache Reports
Licia GrazziAlberto Raggi

Abstract

The aim is twofold. First, to give an insight on the role exerted by different classes of drugs in favouring migraine chronification. Second, to explore the relationship between type and amount of overused medications and history of previous withdrawal treatment and of frequent relapses. All drug classes were found to favour migraine chronification. No data are available for the association with relapses into CM-MOH. Our clinical study shows that patients who underwent previous withdrawal treatments were more likely to be overusers of multiple drug classes and overuse higher amounts of symptomatic medications, particularly, indomethacin, eletriptan and tramadol. Frequent relapsers were more likely to be overusers of opioids or ergotamine and caffeine derivates or of multiple classes, particularly acetylsalicylic acid and ergotamine/caffeine derivates. The joint results our review and clinical study do not seem to support the idea that MOH is drug-specific: rather, it points out that all drug classes may induce migraine chronification. Those drugs which are at higher risk of overuse are among those preferred by the "worst" patients, i.e. those who needed one or more withdrawal treatments for MOH. Our results reinforce the clinic...Continue Reading

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Citations

May 18, 2019·The Journal of Headache and Pain·Willem Sebastiaan van Hoogstraten, Antoinette MaassenVanDenBrink
Mar 11, 2020·Cephalalgia : an International Journal of Headache·Sabine Salhofer-PolanyiChristian Wöber
Jun 26, 2020·Cephalalgia : an International Journal of Headache·Jill C RauFrank Porreca
Jul 4, 2020·Cephalalgia : an International Journal of Headache·Edita NavratilovaFrank Porreca
Apr 2, 2020·Headache·Nicolas VandenbusscheZaza Katsarava
May 27, 2021·Acta Neurologica Scandinavica·Domenico D'AmicoAlberto Raggi

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