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药物过度使用性头痛的描述性综述:从病理生理学到合并症

A Descriptive Review of Medication-Overuse Headache: From Pathophysiology to the Comorbidities.

作者信息

Ljubisavljevic Srdjan, Ljubisavljevic Marina, Damjanovic Radomir, Kalinic Sreten

机构信息

Department for Neurology, University Clinical Centre of Nis, 18000 Nis, Serbia.

出版信息

Brain Sci. 2023 Oct 1;13(10):1408. doi: 10.3390/brainsci13101408.

Abstract

PURPOSE OF REVIEW

Medication-overuse headache (MOH) is an important problem worldwide, with different areas of controversy regarding its entity. This article reviews the risk factors, comorbidities, pathophysiology, clinical presentation, effective management, and prognosis of MOH by summarizing and integrating the results and findings from previously performed more than 15,000 studies (from 2010 to 2023) available from the scientific database of the University Medical Library in the University Clinical Center of Niš, which aimed to investigate and define the complexity of this type of headache.

RECENT FINDING

It has been proposed that all acute migraine medications can lead to MOH, with differences in the propensity of different agents to cause the problem. Early data suggests that triptans and other painkillers used for the acute treatment of migraine may be an exception. Recent studies show that practitioners and the general public are still largely unaware of the problem of medication overuse and its damaging effects.

SUMMARY

Although it is likely that MOH does occur, restricting the number of acute medications is necessary to prevent it. It is also possible that increasing amounts of acute medications are simply a reflection of poorly controlled headaches rather than a cause. Further research needs to be developed to identify more precise mechanisms for effective MOH management and its evolution.

摘要

综述目的

药物过量使用性头痛(MOH)是一个全球性的重要问题,其本质存在不同的争议领域。本文通过总结和整合来自尼什大学临床中心大学医学图书馆科学数据库中此前进行的超过15000项研究(2010年至2023年)的结果和发现,对MOH的危险因素、合并症、病理生理学、临床表现、有效管理及预后进行综述,这些研究旨在调查和界定此类头痛的复杂性。

最新发现

有人提出所有急性偏头痛药物都可能导致MOH,不同药物引发该问题的倾向存在差异。早期数据表明,曲坦类药物及其他用于急性偏头痛治疗的止痛药可能是个例外。近期研究显示,从业者和普通公众在很大程度上仍未意识到药物过度使用问题及其危害。

总结

尽管MOH很可能确实存在,但限制急性药物的使用数量对于预防该病很有必要。急性药物使用量增加也有可能仅仅是头痛控制不佳的一种表现,而非病因。需要开展进一步研究以确定更精确的机制,用于有效管理MOH及其演变过程。

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