Silberstein S D, McCrory D C
Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Headache. 2001 Nov-Dec;41(10):953-67. doi: 10.1046/j.1526-4610.2001.01189.x.
Analgesics containing butalbital compounded with aspirin, acetaminophen, and/or caffeine are widely used for the treatment of migraine and tension-type headache. The butalbital-containing compounds are efficacious in placebo-controlled trials among patients with episodic tension-type headaches. Despite their frequent clinical use for migraine, they have not been studied in placebo-controlled trials among patients with migraine. Barbiturates can produce intoxication, hangover, tolerance, dependence, and toxicity. Butalbital can result in intoxication that is clinically indistinguishable from that produced by alcohol. Butalbital-containing analgesics can produce drug-induced headache in addition to tolerance and dependence. Higher doses can produce withdrawal syndromes after discontinuation. Butalbital-containing analgesics may be effective as backup medications or when other medications are ineffective or cannot be used. Because of concerns about overuse, medication-overuse headache, and withdrawal, their use should be limited and carefully monitored.
含有布他比妥并与阿司匹林、对乙酰氨基酚和/或咖啡因混合的镇痛药被广泛用于治疗偏头痛和紧张型头痛。含布他比妥的化合物在发作性紧张型头痛患者的安慰剂对照试验中有效。尽管它们在偏头痛的临床治疗中经常使用，但尚未在偏头痛患者的安慰剂对照试验中进行研究。巴比妥类药物可导致中毒、宿醉、耐受性、依赖性和毒性。布他比妥可导致中毒，临床上与酒精引起的中毒无法区分。含布他比妥的镇痛药除了会产生耐受性和依赖性外，还会导致药物性头痛。更高剂量在停药后会产生戒断综合征。含布他比妥的镇痛药作为备用药物或在其他药物无效或不能使用时可能有效。由于担心药物滥用、药物过量使用性头痛和戒断反应，应限制其使用并仔细监测。
