PMID: 11903539Mar 21, 2002Paper

Low-dose tizanidine with nonsteroidal anti-inflammatory drugs for detoxification from analgesic rebound headache

Headache
Timothy R Smith

Abstract

To describe an outpatient regimen for analgesic detoxification and resolution of analgesic rebound headache. Frequent analgesic use is believed to promote the transformation of episodic migraine into a chronic, pervasive headache syndrome. Management of pain precipitated by analgesic withdrawal is crucial to treatment success. Outpatient treatment protocols designed to achieve successful withdrawal will reduce costs and potentially lead to more widespread implementation of therapy. Patients with appropriate histories were managed on an outpatient basis for detoxification by discontinuation of the offending analgesic and initiation of treatment with tizanidine and a long-acting nonsteroidal anti-inflammatory drug. Patients kept diaries of pain and medication use. Results were evaluated at 6 and 12 weeks. Patients able to tolerate no or trivial analgesic use (ie, 4 or fewer doses in each 2-week period) were considered responders. At 6 weeks, 36 patients (65%) were responders. At 12 weeks, 38 patients (69%) were responders. The chronic daily headache pattern had resolved at 12 weeks in 34 patients (62%). This treatment protocol was well tolerated and yielded a high degree of efficacy, demonstrating that outpatient management can b...Continue Reading

Citations

Nov 5, 2002·Current Pain and Headache Reports·Ann I ScherWalter Stewart
Nov 12, 2005·Current Pain and Headache Reports·Lutz PagelerVolker Limmroth
Jan 13, 2006·The New England Journal of Medicine·David W Dodick
Apr 2, 2009·Neuropsychiatric Disease and Treatment·Arnaud Fumal, Jean Schoenen
Oct 2, 2012·Annals of Indian Academy of Neurology·Fayyaz AhmedModar Khalil
May 29, 2004·Current Opinion in Neurology·Volker Limmroth, Zaza Katsarava
Sep 18, 2007·Expert Review of Neurotherapeutics·Mark Obermann, Zaza Katsarava
Dec 24, 2005·Expert Opinion on Drug Safety·Mark ObermannZaza Katsarava
May 2, 2006·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Ozlem CoskunLevent E Inan
Mar 18, 2004·Otolaryngologic Clinics of North America·William Numa, Collin S Karmody
Jun 3, 2004·Primary Care·Thomas N Ward
Nov 16, 2014·Current Neurology and Neuroscience Reports·Valerie CheungEsma Dilli
May 21, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·H C DienerJ A Petersen
Apr 2, 2020·Headache·Nicolas VandenbusscheZaza Katsarava
Jul 14, 2020·Mitochondrial DNA. Part A. DNA Mapping, Sequencing, and Analysis·Yusuf BektasDavut Turan
Mar 13, 2021·Current Opinion in Neurology·Mark W Green

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