Journal Title
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Abbravation: The Journal of Headache and Pain
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Authors: P Calabresi L M Cupini
Publish Date: 2005/09
Volume: 6, Issue: 4, Pages: 199-
Abstract
Medication overuse headache MOH is a clinically important entity and it is now well documented that the regular use of acute symptomatic medication by people with migraine or tensiontype headache increases the risk of aggravation of the primary headache MOH is one of the most common causes of chronic migraine–like syndrome Because of easy availability and low expense the greatest problem appears to be associated with barbiturate–containing combination analgesics and over–the–counter caffeine–containing combination analgesics Even though triptan overuse headache is not encountered with great frequency all triptans should be considered potential inducers of MOH There are several different theories regarding the aetiology of MOH including i central sensitisation from repetitive activation of nociceptive pathways ii a direct effect of the medication on the capacity of the brain to inhibit pain iii a decrease in blood serotonin due to repetitive medication administration with alteration of serotonin receptors iv cellular adaptation in the brain and v changes in the periaqueductal grey matter The principal approach to management of MOH is built around cessation of overused medication Without discontinuation of the offending medication improvement is almost impossible to attain Thus the best management advice is to raise awareness and strive for prevention In this article we analyse also the possible mechanisms that underlie sensitisation in MOH by comparing these mechanisms with those reported for other forms of drug addictionBy submitting a comment you agree to abide by our Terms and Community Guidelines If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate Please note that comments may be removed without notice if they are flagged by another user or do not comply with our community guidelines
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