Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España.
Unidad de Cefaleas, Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Neurologia (Engl Ed). 2021 Apr;36(3):229-240. doi: 10.1016/j.nrl.2020.04.029. Epub 2020 Sep 9.
Medication overuse headache is a secondary headache in which the regular or frequent use of analgesics can increase the frequency of the episodes, causing the transition from episodic to chronic headache. The prevalence of medication overuse headache is approximately 1-2%, with higher rates among women aged 30-50 years and with comorbid psychiatric disorders such as depression or anxiety, or other chronic pain disorders. It is important to be familiar with the management of this disease. To this end, the Spanish Society of Neurology's Headache Study Group has prepared a consensus document addressing this disorder.
These guidelines were prepared by a group of neurologists specialising in headache after a systematic literature review and provides consensus recommendations on the proper management and treatment of medication overuse headache. The treatment of medication overuse headache is often complex, and is based on 4 fundamental pillars: education and information about the condition, preventive treatment, discontinuation of the drug being overused, and treatment for withdrawal symptoms. Follow-up of patients at risk of recurrence is important.
We hope that this document will be useful in daily clinical practice and that it will update and improve understanding of medication overuse headache management.
药物过度使用性头痛是一种继发性头痛,其特征是在规律或频繁使用镇痛药后头痛发作频率增加,导致从发作性头痛向慢性头痛转变。药物过度使用性头痛的患病率约为 1-2%,在年龄 30-50 岁的女性中,以及患有抑郁症或焦虑症等精神共病或其他慢性疼痛障碍的患者中,其发病率更高。熟悉这种疾病的管理非常重要。为此,西班牙神经病学学会头痛研究小组制定了一份共识文件,以解决这种疾病。
这些指南是由专门研究头痛的一组神经病学家在系统文献回顾后制定的,就药物过度使用性头痛的正确管理和治疗提出了共识建议。药物过度使用性头痛的治疗往往较为复杂,其基础是四大支柱:对病情的教育和信息、预防性治疗、停止过度使用的药物以及对戒断症状的治疗。对有复发风险的患者进行随访非常重要。
我们希望本文件能有助于日常临床实践,并能更新和提高对药物过度使用性头痛管理的认识。