Factors associated with acute medication overuse in chronic migraine patients (abstract)* * Fatores associados ao uso excessivo de medicação sintomática em enxaqueca crônica (Resumo). Dissertação de Mestrado, Universidade Federal São Paulo (UNIFESP) (Área de Neurociências). Orientador: Mario Fernando Prieto Peres. . Dissertation, São Paulo, 2007
Vera Zukerman-Guendler** ** Address: Rua Itacolomi 601 / 62 - 01239-020 São Paulo SP - Brasil (E-mail: firstname.lastname@example.org).
INTRODUCTION: Chronic migraine is commonly found in healthcare units. Overuse of acute medications, as well as the presence of psychiatric comorbidity, can be considered as important causes of transformation of episodic migraine into chronic (transformed) migraine. There is still a debate regarding the role of overuse of acute medication as an isolated factor in the establishing of chronic migraine. Our hypothesis is that migraine psychiatric comorbidity is the underlying condition that leads episodic migraine to chronic migraine through overuse of acute medication.
OBJECTIVE: To study the relationship between psychiatric diagnosis and symptomatic medication overuse in chronic migraine patients.
METHOD: We evaluated the prevalence of psychiatric disorders in 72 patients diagnosed with chronic migraine with and without symptomatic medication overuse, according to the International Classification for Headache Disorders (2004-2006).
RESULTS: Out of 72 patients, 50 (69%) had chronic migraine with symptomatic medication overuse, and 22 (31%) had chronic migraine without medication overuse. Factors such as age, gender, education level, body mass index, type of acute medication used, headache characteristics, caffeine consumption, and quality of life were not significantly different between the two groups studied. Lifetime anxiety and mood disorders were significantly more common in patients with symptomatic medication overuse (p=0.003, p=0.045, respectively).
CONCLUSION: In chronic migraine patients, the diagnosed lifetime anxiety and mood disorders are important factors to differentiate the patients who overuse symptomatic medications from those who do not. Preventive measures can be designed for the treatment of anxiety and depression, in order to avoid symptomatic medication overuse.
Key words: chronic migraine, symptomatic medication overuse, psychiatric disorders, comorbidity.
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10 Sept 2008
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