Chronic migraine with medication overuse: Treatment outcome and disability at 3 years follow-up

S. Usai, L. Grazzi, F. Andrasik, D. D'Amico, A. Rigamonti, G. Bussone

Research output: Contribution to journalArticle

Abstract

Patients with chronic migraine and medication overuse are particularly difficult to treat. No clear consensus exists about treatment strategies to be used and little data exists about the functional impact of headache in these patients. The purpose of the study was to determine (1) the clinical course of a sample of chronic migraine patients with medication overuse 36 months following treatment intervention and (2) whether functional impairment, assessed by the Migraine Disability Assessment (MIDAS) questionnaire, improved upon treatment. Of 106 patients meeting the criteria for chronic migraine with medication overuse (according to Silberstein and Lipton [1]), 71 went on to complete a structured inpatient treatment, consisting of medication withdrawal and then prophylactic treatment. As a group, the patients were significantly improved at 36-month follow-up, with respect to 2 headache parameters (days of headache per month and number of used medications per month assessed by the diary card) and 2 measures of functional impact extracted from the MIDAS questionnaire (MIDAS total score and frequency of headache). Chronic migraine accompanied with medication overuse led to considerable disability prior to treatment. However, notable improvement both in headache parameters and in disability measures occurred concurrently with treatment. This suggests that successful treatment has more wide-ranging positive benefits beyond mere symptom reduction. To our knowledge, this is the first investigation where the MIDAS questionnaire has been used as an outcome measure in patients with chronic headache to assess disability during such a long follow-up period.

Original languageEnglish
JournalNeurological Sciences
Volume25
Issue numberSUPPL. 3
DOIs
Publication statusPublished - Oct 2004

Fingerprint

Migraine Disorders
Headache
Therapeutics
Headache Disorders
Prescription Drug Overuse
Inpatients
Outcome Assessment (Health Care)
Surveys and Questionnaires

Keywords

  • Chronic migraine
  • Disability
  • Medication overuse
  • Migraine Disability Assessment (MIDAS) questionnaire
  • Outcome

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

Cite this

Chronic migraine with medication overuse : Treatment outcome and disability at 3 years follow-up. / Usai, S.; Grazzi, L.; Andrasik, F.; D'Amico, D.; Rigamonti, A.; Bussone, G.

In: Neurological Sciences, Vol. 25, No. SUPPL. 3, 10.2004.

Research output: Contribution to journalArticle

@article{7b62693f72dc40a2bdbafd8978fabc6d,
title = "Chronic migraine with medication overuse: Treatment outcome and disability at 3 years follow-up",
abstract = "Patients with chronic migraine and medication overuse are particularly difficult to treat. No clear consensus exists about treatment strategies to be used and little data exists about the functional impact of headache in these patients. The purpose of the study was to determine (1) the clinical course of a sample of chronic migraine patients with medication overuse 36 months following treatment intervention and (2) whether functional impairment, assessed by the Migraine Disability Assessment (MIDAS) questionnaire, improved upon treatment. Of 106 patients meeting the criteria for chronic migraine with medication overuse (according to Silberstein and Lipton [1]), 71 went on to complete a structured inpatient treatment, consisting of medication withdrawal and then prophylactic treatment. As a group, the patients were significantly improved at 36-month follow-up, with respect to 2 headache parameters (days of headache per month and number of used medications per month assessed by the diary card) and 2 measures of functional impact extracted from the MIDAS questionnaire (MIDAS total score and frequency of headache). Chronic migraine accompanied with medication overuse led to considerable disability prior to treatment. However, notable improvement both in headache parameters and in disability measures occurred concurrently with treatment. This suggests that successful treatment has more wide-ranging positive benefits beyond mere symptom reduction. To our knowledge, this is the first investigation where the MIDAS questionnaire has been used as an outcome measure in patients with chronic headache to assess disability during such a long follow-up period.",
keywords = "Chronic migraine, Disability, Medication overuse, Migraine Disability Assessment (MIDAS) questionnaire, Outcome",
author = "S. Usai and L. Grazzi and F. Andrasik and D. D'Amico and A. Rigamonti and G. Bussone",
year = "2004",
month = "10",
doi = "10.1007/s10072-004-0306-4",
language = "English",
volume = "25",
journal = "Neurological Sciences",
issn = "1590-1874",
publisher = "Springer-Verlag Italia s.r.l.",
number = "SUPPL. 3",

}

TY - JOUR

T1 - Chronic migraine with medication overuse

T2 - Treatment outcome and disability at 3 years follow-up

AU - Usai, S.

AU - Grazzi, L.

AU - Andrasik, F.

AU - D'Amico, D.

AU - Rigamonti, A.

AU - Bussone, G.

PY - 2004/10

Y1 - 2004/10

N2 - Patients with chronic migraine and medication overuse are particularly difficult to treat. No clear consensus exists about treatment strategies to be used and little data exists about the functional impact of headache in these patients. The purpose of the study was to determine (1) the clinical course of a sample of chronic migraine patients with medication overuse 36 months following treatment intervention and (2) whether functional impairment, assessed by the Migraine Disability Assessment (MIDAS) questionnaire, improved upon treatment. Of 106 patients meeting the criteria for chronic migraine with medication overuse (according to Silberstein and Lipton [1]), 71 went on to complete a structured inpatient treatment, consisting of medication withdrawal and then prophylactic treatment. As a group, the patients were significantly improved at 36-month follow-up, with respect to 2 headache parameters (days of headache per month and number of used medications per month assessed by the diary card) and 2 measures of functional impact extracted from the MIDAS questionnaire (MIDAS total score and frequency of headache). Chronic migraine accompanied with medication overuse led to considerable disability prior to treatment. However, notable improvement both in headache parameters and in disability measures occurred concurrently with treatment. This suggests that successful treatment has more wide-ranging positive benefits beyond mere symptom reduction. To our knowledge, this is the first investigation where the MIDAS questionnaire has been used as an outcome measure in patients with chronic headache to assess disability during such a long follow-up period.

AB - Patients with chronic migraine and medication overuse are particularly difficult to treat. No clear consensus exists about treatment strategies to be used and little data exists about the functional impact of headache in these patients. The purpose of the study was to determine (1) the clinical course of a sample of chronic migraine patients with medication overuse 36 months following treatment intervention and (2) whether functional impairment, assessed by the Migraine Disability Assessment (MIDAS) questionnaire, improved upon treatment. Of 106 patients meeting the criteria for chronic migraine with medication overuse (according to Silberstein and Lipton [1]), 71 went on to complete a structured inpatient treatment, consisting of medication withdrawal and then prophylactic treatment. As a group, the patients were significantly improved at 36-month follow-up, with respect to 2 headache parameters (days of headache per month and number of used medications per month assessed by the diary card) and 2 measures of functional impact extracted from the MIDAS questionnaire (MIDAS total score and frequency of headache). Chronic migraine accompanied with medication overuse led to considerable disability prior to treatment. However, notable improvement both in headache parameters and in disability measures occurred concurrently with treatment. This suggests that successful treatment has more wide-ranging positive benefits beyond mere symptom reduction. To our knowledge, this is the first investigation where the MIDAS questionnaire has been used as an outcome measure in patients with chronic headache to assess disability during such a long follow-up period.

KW - Chronic migraine

KW - Disability

KW - Medication overuse

KW - Migraine Disability Assessment (MIDAS) questionnaire

KW - Outcome

UR - http://www.scopus.com/inward/record.url?scp=16544381151&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=16544381151&partnerID=8YFLogxK

U2 - 10.1007/s10072-004-0306-4

DO - 10.1007/s10072-004-0306-4

M3 - Article

C2 - 15549557

AN - SCOPUS:16544381151

VL - 25

JO - Neurological Sciences

JF - Neurological Sciences

SN - 1590-1874

IS - SUPPL. 3

ER -