TY - JOUR
T1 - Advice alone vs. structured detoxification programmes for medication overuse headache
T2 - A prospective, randomized, open-label trial in transformed migraine patients with low medical needs
AU - Rossi, P.
AU - Di Lorenzo, C.
AU - Faroni, J.
AU - Cesarino, F.
AU - Nappi, G.
PY - 2006/9
Y1 - 2006/9
N2 - The aim of this study was to compare the effectiveness of strong advice to withdraw the overused medication with the effectiveness of two structured pharmacological detoxification strategies in a cohort of patients diagnosed with probable migraine overuse headache (MOH) plus migraine and presenting low medical needs. One hundred and twenty patients participated in the study. Exclusion criteria included: previous detoxification treatments, coexistent medical or psychiatric illnesses and overuse of agents containing opioids, benzodiazepines and barbiturates. Group A received only intensive advice to withdraw the overused medication. Group B underwent a standard out-patient detoxification programme (advice + prednisone + preventive treatment). Group C underwent a standard in-patient withdrawal programme (as in group B + fluid replacement and antiemetics). Withdrawal therapy was considered successful if, after 2 months, the patient had reverted to an episodic pattern of headache and to an intake of symptomatic medication on fewer than 10 days/month. We were able to detoxify 75.4% of the whole cohort, 77.5% of patients in group A, 71.7% of patients in group B and 76.9% of those in group C (P > 0.05). In patients with migraine plus MOH and low medical needs, effective drug withdrawal may be obtained through the imparting of advice alone.
AB - The aim of this study was to compare the effectiveness of strong advice to withdraw the overused medication with the effectiveness of two structured pharmacological detoxification strategies in a cohort of patients diagnosed with probable migraine overuse headache (MOH) plus migraine and presenting low medical needs. One hundred and twenty patients participated in the study. Exclusion criteria included: previous detoxification treatments, coexistent medical or psychiatric illnesses and overuse of agents containing opioids, benzodiazepines and barbiturates. Group A received only intensive advice to withdraw the overused medication. Group B underwent a standard out-patient detoxification programme (advice + prednisone + preventive treatment). Group C underwent a standard in-patient withdrawal programme (as in group B + fluid replacement and antiemetics). Withdrawal therapy was considered successful if, after 2 months, the patient had reverted to an episodic pattern of headache and to an intake of symptomatic medication on fewer than 10 days/month. We were able to detoxify 75.4% of the whole cohort, 77.5% of patients in group A, 71.7% of patients in group B and 76.9% of those in group C (P > 0.05). In patients with migraine plus MOH and low medical needs, effective drug withdrawal may be obtained through the imparting of advice alone.
KW - Advice
KW - Drug withdrawal
KW - Medication overuse headache
KW - Therapy
KW - Transformed migraine
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U2 - 10.1111/j.1468-2982.2006.01175.x
DO - 10.1111/j.1468-2982.2006.01175.x
M3 - Article
C2 - 16919060
AN - SCOPUS:33746908480
VL - 26
SP - 1097
EP - 1105
JO - Cephalalgia
JF - Cephalalgia
SN - 0333-1024
IS - 9
ER -