Kaiser Permanente - Family Medicine, Woodland Hills, CA, USA.
Headache. 2010 Apr;50(4):650-6. doi: 10.1111/j.1526-4610.2010.01633.x. Epub 2010 Mar 5.
Many patients with migraine are poorly responsive to conventional preventive therapies. Comorbid anxiety and depression may contribute to headache refractoriness, but studies of headache preventives have not typically addressed the patient with psychiatric comorbidity. The author has used clonazepam empirically to treat a subgroup of headache patients with associated anxiety, who were poorly responsive to conventional preventives. The use of a benzodiazepine as a headache preventive raises concerns regarding tolerance and addiction. The author presents 3 cases that illustrate different outcomes associated with this therapy, and suggests guidelines for its use.
许多偏头痛患者对常规预防疗法反应不佳。合并焦虑和抑郁可能导致头痛难治，但头痛预防药物的研究通常没有针对合并精神疾病的患者。作者曾凭经验使用氯硝西泮治疗伴有焦虑的头痛患者亚组，这些患者对常规预防药物反应不佳。使用苯二氮䓬类药物作为头痛预防药物会引起对耐受性和成瘾性的担忧。作者提出了 3 个病例，说明了与这种治疗相关的不同结果，并提出了使用该疗法的指南。
