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HEADACHE ASSOCIATED WITH EXCESSIVE USAGE OF ANALGESICS: CLINICAL-PSYCHOLOGICAL AND NEUROPHYSIOLOGICAL ANALYSIS, AND SPECIFICS OF THE PERIOD OF THE PERIOD OF DRUG WITHDRAWAL

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Abstract

According to epidemiological studies, in developed countries from 1 to 2% of the population suffering from headache associated with the abuse of analgesics. The lack of a structured understanding of the abuse headache pathogenesis, the difficulty of well-timed diagnostics and choice of effective treatment resulting of the relapse in 30-50% within 1-5 years. The aim of the study was to investigate the clinical and psycho-physiological characteristics of abuse headache and during the period of withdrawal abuse medication with "detoxification" therapy. According to the study, most patients with abuse headache abused combined analgesics (88%). We are observed a statistically-valid higher level of drug dependence, reactive and personal anxiety, depression and sleep disorders in patients with abuse headache. Development of drug withdrawal period was different in the groups with migraine and tension-type headache (lower intensity of headache was observed in the group with migraines), as well as in groups with one-stage and gradual drug withdrawal (headache course with one-stage withdrawal clinically was more easily). Increase in the overall amplitude response N75/P100, with an emphasis in the period of drug withdrawal and lack of habituation N75/P100 in patients with AGB were detected. This may indicate the increase in cortical excitability due to reducing the inhibitory thalamo-cortical and intracortical influences. Analysis of the results proves the effectiveness of the usage «detoxification» therapy in the acute phase of abuse drug withdrawal, and gives reason to recommend it to practical use in conjunction with the prescription of preventive treatment.

About the Authors

A. V. Sergeev
I.M. Sechenov First Moscow State Medical University (MSMU)
Russian Federation
Department of Neurology and Clinical Neurophysiology, SIC


M. I. Meshcherina
I.M. Sechenov First Moscow State Medical University (MSMU)
Russian Federation
Department of Neurology and Clinical Neurophysiology, SIC


G. R. Tabeeva
I.M. Sechenov First Moscow State Medical University (MSMU)
Russian Federation
Department of Neurology and Clinical Neurophysiology, SIC


References

1. Айзенберг И.В, Кацарава З. Хроническая абузусная головная боль. Российский журнал « Боль» №1(6), 2005, 57-65

2. Куцемелов И. Б., Табеева Г. Р. Эпидемиология первичной головной боли (по данным популяционного исследования взрослого населения г. Ростова–на–Дону). Журнал «Боль» – 2004. – 4(5). – С.25–31.

3. Табеева Г.Р. Яхно Н.Н. Мигрень. – М.: ГОЭТАР-Медиа, 2011 – С. 223-245.

4. Табеева Г.Р., Азимова Ю.Э., Маргулис М.И. Рефрактерная мигрень: от патогенеза к рациональной терапии. Российский медицинский журнал. 2010.-N 16.-С.981-985.

5. Bigal ME, Rapaport AM, Sheftell FD, Tepper SJ, Lipton RB. Transformed migraine and medication overuse in a tertiary headache centre-clinical characteristics and treatment outcomes. Cephalalgia. 2004; 24: 483-490.

6. Bigal ME, Serrano D, Buse D, Scher A, Stewart WF,Lipton RB. Acute migraine medications and evolution from episodic to chronic migraine: A longitudinal populationbased study. Headache. 2008; 48: 1157-1168.

7. Bøe MG, Mygland Å, Salvesen R. Prednisolone does not reduce withdrawal headache. A randomized, double-blind study. Neurology. 2007; 69: 26-31.

8. Breslau N, Schultz LR, Stewart WF, Lipton R, Welch KM. Headache types and panic disorder: directionality and specificity. Neurology 2001; 56: 350-354.

9. Colas R, Munoz P, Temprano R, et al. Chronic daily headache with analgesic overuse: epidemiology and impact on quality of life. Neurology 2004; 62: 1338–1342.

10. Diener HC, Limmroth V Medicationoverused headache: a worldwide problem. Lancet Neurol. 2004; 3:475-483

11. Dodick D, Freitag F. Evidence-based understanding of medication-overuse headache: Clinical implications. Headache. 2006; 46 (Suppl. 4): 202-211.

12. Evers S, Suhr B, Bauer B, Grotemeyer KH, Husstedt IW.A retrospective long-term analysis of the epidemiology and features of drug-induced headache. J Neurol. 1999; 246: 802-809.

13. Ferrari A, Cicero AFG, Bertolini A, Leone S, Pasciullo G, Sternieri E. Need for analgesics/ drugs of abuse: A comparison between headache patients and addicts by the Leeds Dependence Questionnaire (LDQ). Cephalalgia. 2005; 26: 187-193.

14. Freitag F, Lake AL III, Lipton R, Cady R, Diamond S, Silberstein S. Inpatient treatment of headache: an evidence-based assessment. Headache. 2004; 44:342–360.

15. Grazzi L, Andrasik F, D’Amico D, Leone M, Usai S, Kass S, Bussone G (2002) Behavioral and pharmacologic treatment of transformed migraine with analgesic overuse: outcome at 3 years. Headache 2002; 42:483–490.

16. Grazzi L, Andrasik F, D’Amico D, Usai S, Kass S, Bussone G. Disability in chronic migraine patients with medication overuse: Treatment effects at 1 year follow-up. Headache 2004; 44:678–683

17. Grazzi L, Andrasik F, Usai S, Bussone G. In-patient vs day-hospital withdrawal treatment for chronic migraine with medication overuse and disability assessment: results at one year follow-up. Neurol sci. 2008; 29(Suppl. 1):S161–S163

18. Headache Classification. Subcommittee of the International Headache Society. The International classification of headache disorders II Ed. Cephalalgia. 2004; 24(Suppl. 1): 9-160.

19. Hering R, Steiner TJ. Abrupt outpatient withdrawal of medication in analgesicabusing migraineurs. Lancet 1991; 337:1442–1443.

20. Katsarava Z, Fritsche G, Muessig M, et al. Clinical features of withdrawal headache following overuse of triptans and other headache drugs. Neurology 2001; 57: 1694–1698.

21. Kupers R, Frokjaer VG, Naert A, et al. A PET [18F] altanserin study of 5-HT2A receptor binding in the human brain and responses to painful heat stimulation. Neuroimage. 2009; 44:1001-1007.

22. Lake AE, Saper J, Madden S, Kreeger C. Comprehensive inpatient treatment for intractable migraine: a prospective longterm outcome study. Headache. 1993; 33:55–62

23. Limmroth V, Katsarava Z, Fritsche G, et al. Features of medication overuse headache following overuse of different acute headache drugs. Neurology 2002; 59: 1011- 1014.

24. Mackowiak M, Chocyk A, Sanak M, Czyrak A, Fijał K, Wedzony K. DOI, an agonist of 5-HT2A/2C serotonin receptor, alters the expression of cyclooxygenase-2 in the rat parietal cortex. J Physiol Pharmacol. 2002; 53:395-407.

25. Meng EI., Dodick D., Ossipov M., Porreca F. Pathophysiology of medication overuse headache: Insights and hypotheses from preclinical studies. Cephalalgia. 2011; 31(7):851-60.

26. Mesherina M.I, Tabeeva G.R, Sergeev A.V., Оsipova V.V. Visual evoked potentials during withdrawal period in patients with medication overuse headache. Abstract of 15th International Headache Congress. Berlin 2011.

27. Monzon M, Lainez M Quality of life in migraine and chronic daily headache patients. Cephalalgia 1998; 18:638–643.

28. Pini LA, Bigarelli M, Vitale G, Sternieri E. Headaches associated with chronic use of analgesic: a therapeutic approach. Headache. 1996; 36:433–439.

29. Scher AI, Lipton RB, Stewart WF, Bigal M. Patterns of medication use by chronic and episodic headache sufferers in the general population: Results from the frequent headache epidemiology study. Cephalalgia. 2010; 30(3): 321-8.

30. Schnider P, Aull S, Baumgartner C. Longterm outcome of patients with headache and drug abuse after inpatient withdrawal: Five-year follow-up. Cephalalgia. 1996;16:481-485.

31. Schwarz A, Farber U, Glaeske G. Daten zu Analgetikakonsum und nalgetikanephropathie in der Bundesrepublik. Öffentliches Gesundheitswesen 1985;47:298.

32. Silberstein SD, Olesen J, Bousser M-G, et al. The International Classification of Headache Disorders, 2nd edition (ICHD-II)-revision of criteria for Medication-overuse headache. Cephalalgia. 2005;25: 460-465.

33. Srikiatkhachorn A, Suwattanasophon C, Ruanpattanatawee U, Phasuwan-Pujito P. 5-HT2A receptor activation and nitric oxide synthesis: A possible mechanism determining migraine attacks. Headache. 2002; 42:566-574.

34. Srikiatkhachorn A, Tarasub N, Govitrapong P. Effect of chronic analgesic exposure on the central serotonin system. A possible mechanism of analgesic abuse headache. Headache. 2000; 40:343-350.

35. Supornsilpchai W., Supang M.G., Srikiatkhachorn A. Involvement of pronociceptive 5-HT2A receptor in the pathogenesis of medication-overuse headache. Headache 2010; 50:185-197.

36. Thibault K, Van Steenwinckel J, Brisorgueil MJ, et al. Serotonin 5-HT2A receptor involvement and Fos expression at the spinal level in vincristine induced neuropathy in the rat. Pain. 2008; 140: 305-322.37. Trucco M; Meineri P; Ruiz L, Gionco M. Medication overuse headache: withdrawal and prophylactic therapeutic regimen. Headache 2010;50:989-997.

37. Kaji Y, Hirata K. Characteristics of Mood Disorders in Japanese Patients with Medication-Overuse Headache. Inter Med. 48: 981-986, 2009.

38. Zidverc-Trajkovic J, Pekmezovic T, Jovanovic Z, et al. Medication overuse headache: Clinical features predicting treatment outcome at 1-year follow-up. Cephalalgia. 2007; 27:1219-1225.


Review

For citations:


Sergeev A.V., Meshcherina M.I., Tabeeva G.R. HEADACHE ASSOCIATED WITH EXCESSIVE USAGE OF ANALGESICS: CLINICAL-PSYCHOLOGICAL AND NEUROPHYSIOLOGICAL ANALYSIS, AND SPECIFICS OF THE PERIOD OF THE PERIOD OF DRUG WITHDRAWAL. Epilepsy and paroxysmal conditions. 2011;3(3):21-28. (In Russ.)

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ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)