[Chronic daily headache: management and rehabilitation]

Clin Ter. 2006 Mar-Apr;157(2):153-7.
[Article in Italian]

Abstract

In 2001, WHO evidenced headache among the first twenty disability agents in the world. The International Classification of Headache Disorders, II version (ICHD-II) recognises 24 types of chronic headache and states primary headaches as chronic when attacks appear for more than 15 days per month, for at least three months. Migraine given by drugs overuse, defined by ICDH-II in 2004 (and revised in 2005) as MOH, represents a common and debilitating disorder, which can be defined as generation, perpetuation and persistence of intense chronic migraine caused by the frequent and excessive use of (symptomatic) drugs, giving an immediate relief. MOH is associated with overuse of a combination of analgesics, barbiturates, opiods, Ergot alkaloids, aspirin, FANS, caffeine and triptans. Furthermore, some psychological and behavioural states seem particularly important in promoting and sustaining drugs abuse. The management and rehabilitation of patients affected by CDH, over-using symptomatic drugs, consists in the suspension and gradual reduction of their assumption, because of tolerance and addiction possibilities. Therapeutic success, defined as total absence of headache or frequency reduction over 50% in a period of time from 1 to 6 months, stands around 72-74%.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Analgesics / adverse effects
  • Analgesics / therapeutic use
  • Comorbidity
  • Drug Therapy, Combination
  • Headache Disorders / chemically induced
  • Headache Disorders / classification
  • Headache Disorders / rehabilitation*
  • Headache Disorders / therapy
  • Humans
  • Patient Education as Topic
  • Serotonin Receptor Agonists / adverse effects
  • Serotonin Receptor Agonists / therapeutic use
  • Substance Withdrawal Syndrome / rehabilitation
  • Treatment Outcome
  • World Health Organization

Substances

  • Analgesics
  • Serotonin Receptor Agonists