Breaking the cycle of medication overuse headache.
When patients who have frequent, disabling migraines take medications to relieve their symptoms, they run the risk that the attacks will increase in frequency to daily or near-daily as a rebound effect comes into play. This pattern, called medication overuse headache, is more likely to happen with butalbital and opioids than with migraine-specific drugs, as partial responses lead to recurrence, repeat dosing, and, eventually, overuse. Breaking the cycle involves weaning the patient from the overused medications, setting up a preventive regimen, and setting strict limits on the use of medications to relieve acute symptoms.
Tepper
Stewart J
SJ
Center for Headache and Pain, Neurological Institute, T33, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. teppers@ccf.org
Tepper
Deborah E
DE
D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D001463:Barbiturates / Q000008:administration & dosage / Q000009:adverse effects*; D004198:Disease Susceptibility; D051271:Headache Disorders, Secondary / Q000139:chemically induced* / Q000517:prevention & control*; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy*; D010353:Patient Education as Topic; D012008:Recurrence; D012307:Risk Factors; D013375:Substance Withdrawal Syndrome; D019966:Substance-Related Disorders / Q000517:prevention & control*; D009626:Terminology as Topic; D014363:Tryptamines / Q000008:administration & dosage / Q000009:adverse effects*
D000701:Analgesics, Opioid; D001463:Barbiturates; D014363:Tryptamines; C004470:butalbital