Excessive opioid use and the development of chronic migraine

@article{Bigal2009ExcessiveOU,
  title={Excessive opioid use and the development of chronic migraine},
  author={Marcelo Eduardo Bigal and Richard B. Lipton},
  journal={PAIN{\textregistered}},
  year={2009},
  volume={142},
  pages={179-182}
}

Figures from this paper

Chronic migraine—classification, characteristics and treatment
TLDR
The evolution of the understanding of chronic migraine, including its epidemiology, pathophysiology, clinical characteristics and treatment options, is discussed, including a wealth of expert opinion and a few evidence-based treatment options.
A Comprehensive Review of Over-the-counter Treatment for Chronic Migraine Headaches
TLDR
Over-the-counter medications are an important component of migraine therapy and are considered a first-line therapy for most migraineurs, and these medications have shown strong efficacy when used as first- line treatments for mild-to-moderate migraine attacks.
Medication-Overuse Headache
TLDR
MOH development is linked to baseline frequency of headache days per month, acute medication class ingested, frequency of acute medications ingested, and other risk factors.
Symptomatic Treatment of Migraine: When to Use NSAIDs, Triptans, or Opiates
TLDR
Evidence-based guidelines and clinical experience support the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the management of mild to moderate migraine attacks and recommend migraine-specific agents (triptans and dihydroergotamine) when the attacks are more severe or have consistently failed to respond to theUse of NSAIDs in the past.
New therapeutic developments in chronic migraine
TLDR
Advances in preventive treatment and a better understanding of its risk factors will allow clinicians to better identify individuals at greatest risk and prevent the development of chronic migraine.
Opioids can be useful in the treatment of headache
TLDR
The results coming from small clinical series are described, suggesting that in expert hands daily long-acting opioids provide an option for the treatment of some individuals with chronic intractable headaches.
Inpatient Management of Migraine
Migraine is a frequently disabling disorder which may require inpatient treatment. Admission criteria for migraine include intractable migraine, nausea and/or vomiting, severe disability, and
Tolerance to Headache Medications
  • M. Bigal
  • Medicine, Psychology
    Headache
  • 2011
TLDR
The topic is incompletely studied and many of the concepts that are applicable to pain syndromes are also relevant to headache disorders, and 5 recent papers that may add to knowledge to the topic are reviewed and commented on.
...
...

References

SHOWING 1-10 OF 39 REFERENCES
Chronic migraine in the population
TLDR
Chronic migraine (CM) is more disabling than episodic migraine in the population, and although most individuals with CM sought medical care for this disorder, the majority did not receive specific acute or preventive medications.
Transformed Migraine and Medication Overuse in a Tertiary Headache Centre — Clinical Characteristics and Treatment Outcomes
TLDR
Evaluating patterns of analgesic overuse in patients consulting a headache centre and comparing the outcomes in a group of patients who discontinued medication overuse to those of a group who continued the overuse, in patients with similar age, sex and psychological profile found that successful detoxification is necessary to ensure improvement in the headache status.
Field Testing Alternative Criteria for Chronic Migraine
TLDR
Criteria for chronic migraine and CM+ should be revised to require at least 8 days of migraine or probable migraine per month, in individuals with 15 or more days of headache per month.
Migraine: Epidemiology, Impact, and Risk Factors for Progression
TLDR
The epidemiology of and the risk factors for migraine described in population studies are reviewed, the burden of disease and the socioeconomic costs of migraine are discussed, and evidence suggests that a subgroup of migraine patients may have a clinically progressive disorder.
New Appendix Criteria Open for a Broader Concept of Chronic Migraine
TLDR
The International Headache Classification Committee has worked out the more inclusive criteria for CM and MOH and it is now recommended that the MOH diagnosis should no longer request improvement after discontinuation of medication overuse but should be given to patients if they have a primary headache plus ongoing medication over use.
Incidence and predictors for chronicity of headache in patients with episodic migraine
TLDR
The authors followed 532 consecutive patients with episodic migraine (<15 days/month) for 1 year andixty-four patients (14%) developed chronic headache (CH), with odds ratios higher in patients with and without medication overuse.
Probable medication-overuse headache
TLDR
The benefit of withdrawal in already established medication overuse is demonstrated and the existence of medication-overuse headache as a clinical entity is supported.
Analgesic use: A predictor of chronic pain and medication overuse headache
TLDR
Overuse of analgesics strongly predicts chronic pain and chronic pain associated with analgesic overuse 11 years later, especially among those with chronic migraine.
Out-Patient Detoxification in Chronic Migraine: Comparison of Strategies
TLDR
It is concluded that CM patients with moderate overuse of SM other than opioids may be detoxified on an out-patient basis regardless of the strategy adopted with regard to the use of regular drugs during the initial days of withdrawal, but prednisone and naratriptan may be useful for reducing withdrawal symptoms and rescue medication consumption.
...
...