The patient with medication overuse: clinical management problems.
Patients with chronic headache arise many problems in clinical management, often strictly related to medication overuse. IHS classification did not clear the different clinical presentation and a chapter dedicated to this problem is lacking. This condition is very frequently associated with psychiatric illness, so that the clinical features become more complex over the years. Most of patients share a past clinical condition of episodic migraine; this aspect is very important facing the therapeutical phase, because after discontinuing medication overuse, if present, the treatment must be direct toward this disease. To treat a patient with analgesic, or ergotamine, or triptan abuse, require much caution because stopping the drug may arise new problems, such as different headache, abstinence syndrome, epileptic seizures etc. We review the different possibility that we have to manage the overuser patient.
Frediani
F
F
Neurological Department, Policlinico S. Pietro, Via Forlanini 15, I-24036 Ponte S. Pietro (BG), Italy.
Cannatà
A P
AP
Magnoni
A
A
Peccarisi
C
C
Bussone
G
G
D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects*; D001526:Behavioral Symptoms / Q000139:chemically induced; D002908:Chronic Disease; D003863:Depression / Q000139:chemically induced*; D005500:Follow-Up Studies; D006261:Headache / Q000145:classification / Q000188:drug therapy*; D020773:Headache Disorders / Q000145:classification / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy; D010554:Personality Disorders / Q000139:chemically induced; D011379:Prognosis; D016896:Treatment Outcome
D000700:Analgesics