Response to overuse of some headache meds

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Posted by Bob Johnson ( on December 14, 2001 at 10:39:42:

After Overuse, Type of Medication Determines Withdrawal Headache Symptoms

NEW YORK (Reuters Health) Dec 13 - The duration and severity of withdrawal headaches and accompanying autonomic symptoms following overuse of headache medication depend on the type of overused drug.

Dr. Volker Limmroth and colleagues from University Hospital Essen, Germany, conducted a prospective study of 95 patients to assess withdrawal headache following overuse of various headache medications, including single and combination analgesics, ergots, and triptans.

Patients who overused triptans had a significantly shorter duration of withdrawal headache (4.1 days) compared with patients who overused ergots (6.7 days) or analgesics (9.5 days; p < 0.002), according to the report in the November 13th issue of Neurology.

"By day 14 (last day of observation), 85% of the patients in the triptan group were headache-free, whereas only 57% of patients in the ergot group and 23% in the analgesic group reported themselves to be headache-free," the authors explain.

They observed no difference between the groups in terms of mean headache intensity on the first day of withdrawal (p = 0.821). However, by day 14, patients overusing triptans had lower mean headache intensity (0.08) than patients overusing ergots (0.4) or analgesics (0.9; p < 0.005).

"Because only patients with migraine, but no patient with tension-type headache, overused triptans, withdrawal headache was shorter in the group of patients with migraine alone (6.7 days versus 9.6 days for patients with tension-type headache and 8.5 days for patients with combination headache, p < 0.02)," Dr. Limmroth and colleagues note.

Neurology 2001;57:1694-1698.

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