Healthy Skepticism Library item: 5943
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: Journal Article
Kossoff EH, Mankad DN.
Medication-overuse headache in children: is initial preventive therapy necessary?
J Child Neurol 2006 Jan 01; 21:(1):45-8
http://www.bcdecker.com/pubMedLinkOut.aspx?pub=JCNO&vol=21&iss=1&page=45
Abstract:
Chronic daily headaches can be a difficult problem in children as well as adults. Over half of the cases of chronic daily headaches in adults are thought to be due to medication-overuse headache, and treatment consists of discontinuation of these analgesics. Since many patients are also treated with preventive agents at the time of analgesic withdrawal, it is difficult to determine whether discontinuation alone is the most effective treatment. A retrospective study was performed to evaluate the outcomes of 43 children (ages 6-17 years) with medication-overuse headache 1 month after withdrawal of analgesics: 20 children received daily doses of a preventive medication, and 23 received no preventive medication. Headache reduction was assessed 1 month later. There was no difference in the percentage, with 90% or greater headache reduction at 1 month between children treated by withdrawal of analgesic drugs only and those receiving preventive medications (57% vs 50%, respectively). There was no influence of age, gender, use of triptans as rescue agents, or caffeine use on outcomes. A previous duration of headaches over 2 years was negatively correlated with overall outcome. We advise discontinuation of analgesics in all children with medication-overuse headache, without the necessity for starting daily preventive agents concurrently. Should headaches persist after 1 month, such agents can be added.
Keywords:
Adolescent
Analgesics/adverse effects*
Anti-Inflammatory Agents, Non-Steroidal/adverse effects*
Caffeine/adverse effects
Child
Female
Follow-Up Studies
Headache Disorders, Secondary/chemically induced*
Headache Disorders, Secondary/prevention & control*
Humans
Male
Retrospective Studies
Treatment Outcome
Tryptamines/administration & dosage
