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Vol. 45, No. 4, 2001
Issue release date: May 2001
Section title: Original Paper
Eur Neurol 2001;45:229–235
(DOI:10.1159/000052134)

Drug-Induced Headache: Long-Term Follow-Up of Withdrawal Therapy and Persistence of Drug Misuse

Fritsche G. · Eberl A. · Katsarava Z. · Limmroth V. · Diener H.C.
Department of Neurology, University of Essen, Germany

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 5/18/2001
Issue release date: May 2001

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 5

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: http://www.karger.com/ENE

Abstract

Patients suffering from migraine, tension-type headache (TTH), or combined headache (CH) are at risk of developing drug-induced headache (DIH) due to regular use of analgesics, ergot alkaloids, and triptans. The aim of our study was to determine (1) the clinical features of DIH, (2) the outcome of withdrawal therapy using high methodological standards, and (3) predictors which could explain the high relapse rate (more than 40%) after a previously successful withdrawal therapy. We retrospectively reviewed 103 patients with migraine or TTH who underwent withdrawal therapy between 1994 and 1998. The long-term follow-up (2–4 years after therapy) was conducted by phone and by specially trained psychologists using a structured interview which enclosed characteristics of headache and medication behavior as well as patients global assessment of success. Complete sets of data were available from 83 patients (38 migraine, 26 TTH, 19 CH). The most frequently abused drugs were caffeine-combined analgesics (24%), followed by caffeine-combined ergotamines (19%), pure ergot alkaloids (17%), and monoanalgesics (17%). 48.5% of the patients suffered an abuse relapse within 4 years and developed the complete features of DIH again. Analgesic and ergot alkaloid combinations with caffeine lead significantly more often to a relapse. A long-term successful therapy is connected with a significant reduction of the frequency of headache attacks. Under relapse conditions, the patients reached their former headache frequency level. The data show a higher relapse rate than previously assumed and that certain substance groups bear a higher relapse risk.

© 2001 S. Karger AG, Basel


  

Author Contacts

Guenther Fritsche
Department of Neurology, University of Essen
Hufelandstrasse 55
D–45122 Essen (Germany)
Tel. +49 201 723 3263, Fax +49 201 723 5901, E-Mail guenther.fritsche@uni-essen.de

  

Article Information

Received: Received: August 17, 2000
Accepted: October 19, 2000
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 5, Number of References : 14

  

Publication Details

European Neurology
Founded 1897 as ‘Monatsschrift für Psychiatrie und Neurologie’

Vol. 45, No. 4, Year 2001 (Cover Date: Released May 2001)

Journal Editor: J. Bogousslavsky, Lausanne
ISSN: 0014–3022 (print), 1421–9913 (Online)

For additional information: http://www.karger.com/journals/ene


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 5/18/2001
Issue release date: May 2001

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 5

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: http://www.karger.com/ENE


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.