[Efficiency of pharmacological treatment of chronic post-traumatic headaches].
BACKGROUND
Chronic post-traumatic headache (CPH) is a complex clinical entity. The clinical features of CPH are variable and may resemble those of primary headaches (migraine, tension-type headache or cluster headache), as well as of cervicogenic headache. Therefore, the treatment must be individualized according to the headache type. There were few studies addressing the effectiveness of pharmacological treatment in patients with CPH.


OBJECTIVE
The aim of the present study was to analyze the efficiency of pharmacological treatment with analgesic drugs and concomitant psychotropic drugs in outpatients with CPH.


METHODS
We studied 59 outpatients with CPH (39 males and 20 females, mean age 36+/-13 years) who were taking analgetic monotherapy for their headache (simple analgesics, NSAIDs, atypic analgesics and triptans in subjects with migraine) and in case of comorbid psychic disorders some of them were taking psychotropic drugs. The efficiency of drug therapy was evaluated by the outcome scale based on the patients' headache diaries (outcome graded as improved, unchanged or worsened).


RESULTS
Most of the study patients reported that their CPH was unchanged. The improvement was greater in the subgroup of cervico-occipital headache sufferers, but it was not statistically significant when compared to other subgroups. Post-traumatic migraine was the type of headache most refractory to drug therapy. The patients who took analgesics without psychotropic drugs had a reliably (p<0.05) better improvement of their headache.


CONCLUSIONS
Analgesic drug monotherapy did not produce favorable therapeutic response in patients with CPH. Appropriate psychopharmacotherapy should be prescribed to CPH patients with psychiatric comorbidity.
Janculjak
Davor
D
Klinika za neurologiju, Klinicka bolnica Osijek, Osijek, Hrvatska. janculjak.davor@kbo.hr
Fingler
Mira
M
Bras
Marijana
M
Hećimović
Ivan
I
Splavski
Bruno
B
Vuković
Vlasta
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051298:Post-Traumatic Headache / Q000150:complications / Q000188:drug therapy*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D016896:Treatment Outcome
D000700:Analgesics; D011619:Psychotropic Drugs