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药物过度使用性头痛:当前证据与管理策略综述

Medication overuse headache: a review of current evidence and management strategies.

作者信息

Kebede Yabets Tesfaye, Mohammed Bekri Delil, Tamene Beimnet Ayenew, Abebe Abel Tezera, Dhugasa Rabbi Waqshum

机构信息

School of Medicine, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.

Department of Nursing, Adama General Hospital and Medical College, Adama, Ethiopia.

出版信息

Front Pain Res (Lausanne). 2023 Aug 8;4:1194134. doi: 10.3389/fpain.2023.1194134. eCollection 2023.

Abstract

The third edition of the International Classification of Headache Disorders (ICHD-3) defines medication-overuse headache (MOH) as a headache that develops when a person regularly uses acute or symptomatic headache medications excessively (10 or more, or 15 or more days per month, depending on the medication) for a period of time longer than 3 months. Even though it may not be reported as frequently as it actually is, it affects about 5% of the general population on average. It typically happens following repeated anti-pain medication use for pre-existing headache disorders, such as migraines. Anti-pains can also be used frequently in patients with pre-existing headache disorders for reasons other than treating headaches, such as psychological drug attachment. MOH is linked to a number of illnesses, such as anxiety, depression, and obsessive compulsive disorder (OCD). Both simple and complex types are possible. Additionally, there is no universal consensus on how to treat MOH, but drug discontinuation is the best course of action. Using the medical subject headings "Medication Overuse Headache," "Migraine Headache," "Tension Headache," "Chronification of Headache," and "Antipains," an all-language literature search was done on PubMed, Google Scholar, and Medline up until March 2023. We looked into the epidemiology, risk factors, pathophysiology, clinical characteristics, comorbidities, diagnosis, management, and preventative measures of MOH in the literature. This article focuses on the MOH research themes.

摘要

《国际头痛疾病分类》第三版(ICHD - 3)将药物过量使用性头痛(MOH)定义为:当一个人长期(超过3个月)过度使用急性或对症性头痛药物(根据药物不同,每月10天或更多,或15天或更多)时所引发的头痛。尽管其实际发生率可能未被频繁报道,但平均约影响5%的普通人群。它通常发生在对已有的头痛疾病(如偏头痛)反复使用止痛药物之后。止痛药物也可能因治疗头痛以外的原因(如心理上对药物的依赖)而在已有头痛疾病的患者中频繁使用。MOH与多种疾病有关,如焦虑症、抑郁症和强迫症(OCD)。它有简单型和复杂型。此外,对于如何治疗MOH尚无普遍共识,但停用药物是最佳行动方案。使用医学主题词“药物过量使用性头痛”“偏头痛性头痛”“紧张性头痛”“头痛的慢性化”和“止痛药物”,截至2023年3月在PubMed、谷歌学术和Medline上进行了全语言文献检索。我们在文献中研究了MOH的流行病学、危险因素、病理生理学、临床特征、合并症、诊断、管理和预防措施。本文重点关注MOH的研究主题。

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