Headache Research, Wolfson CARD, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 20 Newcomen St, London, SE1 1YR, UK.
Present address: Medicines Discovery Catapult, Block 35, Mereside, Alderley Park, Cheshire, SK10 4TG, UK.
J Headache Pain. 2021 Apr 28;22(1):32. doi: 10.1186/s10194-021-01224-8.
Chronic headache is particularly prevalent in migraineurs and it can progress to a condition known as medication overuse headache (MOH). MOH is a secondary headache caused by overuse of analgesics or other medications such as triptans to abort acute migraine attacks. The worsening of headache symptoms associated with medication overuse (MO) generally ameliorates following interruption of regular medication use, although the primary headache symptoms remain unaffected. MO patients may also develop certain behaviors such as ritualized drug administration, psychological drug attachment, and withdrawal symptoms that have been suggested to correlate with drug addiction. Although several reviews have been performed on this topic, to the authors best knowledge none of them have examined this topic from the addiction point of view. Therefore, we aimed to identify features in MO and drug addiction that may correlate. We initiate the review by introducing the classes of analgesics and medications that can cause MOH and those with high risk to produce MO. We further compare differences between sensitization resulting from MO and from drug addiction, the neuronal pathways that may be involved, and the genetic susceptibility that may overlap between the two conditions. Finally, ICHD recommendations to treat MOH will be provided herein.
慢性头痛在偏头痛患者中尤为常见，并且可能发展为一种称为药物过度使用性头痛（MOH）的疾病。MOH 是由过度使用镇痛药或其他药物（如曲坦类药物）来终止急性偏头痛发作引起的继发性头痛。尽管原发性头痛症状不受影响，但停止常规用药后，与药物过度使用相关的头痛症状通常会改善。MOH 患者还可能出现某些行为，如仪式性药物给药、心理药物依赖和戒断症状，这些行为已被认为与药物成瘾有关。尽管已经对这个主题进行了几次综述，但据作者所知，其中没有一篇从成瘾的角度来探讨这个主题。因此，我们旨在确定 MOH 和药物成瘾之间可能相关的特征。我们首先介绍可能导致 MOH 和具有高产生 MO 风险的镇痛药和药物类别。我们进一步比较了 MO 和药物成瘾引起的敏化作用、可能涉及的神经元通路以及这两种情况之间可能重叠的遗传易感性之间的差异。最后，本文将提供 ICHD 治疗 MOH 的建议。
