Abuse headaches

Not every doctor, not to mention patients, is familiar with such a pathology as abusus headaches. And this disease occurs more than often: they suffer approximately every hundredth person, or even 2 out of a hundred, more often - women. Abusus is an abuse of something, in this case - medicines for the treatment of primary cephalgia( headaches).Many medications that cause this disease are allowed for sale without a prescription and are widely used by patients.

From our article you will learn about what drugs cause abusive headaches, how this disease manifests itself, and also about the principles of diagnosis and the tactics of treating it.

Causes and mechanism of development of

The leading etiologic factor of abusic( otherwise, medicinal, "ricochet") headaches is inappropriate administration of analgesics for the treatment of primarycephalgia - migraine, tension headache and others. Provoke the development of this pathology may non-steroidal anti-inflammatory drugs( non-narcotic analgesics), opiates, triptans, ergotamine, caffeine, codeine, much less often - antihistamines and some other groups of medicines.¾ cases of abusic headache are caused by the use of combined medicines, including NSAIDs, codeine and other components, rather than with monotherapy by any one of them.

The main risk factor is the regular intake of the above medicines. It is important how many days a month the patient takes this or that drug. In the diagnostic criteria of an abusus headache, it is a question of using a specific medication for at least 10 days( or more) for 1 month, that is, at least 2-3 days a week, 3 consecutive months. In cases of alternation of frequent use of drugs with long periods without them, the development of abusus headaches is unlikely.

Certain other factors play a role in the development of this pathology. First of all, these are anxious and depressive disorders: they contribute to the development of psychological dependence of the patient on medicines, which leads to their abuse. Abuzus causes headaches in almost half of people with depression. The second factor is a genetic predisposition to the aforementioned mental disorders, as well as to alcoholism and a drug abusus.

With abuse of pain medication, primary cephalgia( associated with overexertion, migraine) is gradually transformed into chronic. To date, the mechanism of these processes is not completely known. Analgesics taken in the treatment of other diseases( osteochondrosis, arthritis and others), abuzusnye headaches do not cause.

Symptoms of

Abusional headache can be worrisome to patients constantly, decreasing only for a short time after taking the causative drug.

As mentioned above, this pathology is secondary. That is, at first the patient is disturbed by symptoms typical for a tension headache or migraine. On the recommendation of a doctor or independently, he takes medications that alleviate this pain. Over time, these drugs become less effective, the patient takes them more often and at a higher dose. Gradually, the primary headache is transformed into an abuzus.

It is characterized by such symptoms:

• bothers the patient day in and day out, from morning to night, however it is more pronounced in the morning hours, and during the day can change the intensity;
• patients characterize it as a moderate or weak, dull, aching character, localized in the frontal-occipital region or diffuse, bilateral;
• is amplified under any kind of load: both physical and mental, as well as discontinuation of the drug that causes it( this withdrawal syndrome);
• after taking an anesthetic, the headache is slightly and briefly reduced, but soon resumes, and this causes the person to take the medication again and again.

Such pains bother the patient more than 15 days a month. It is possible to develop mixed cephalgia, manifested by the symptoms of both migraine, and tension headache at the same time.

Principles of diagnosis

In fact, the diagnosis of "abusus headache" is established retrospectively. That is, to make sure it will only allow the disappearance of a headache or a return to the initial sensations after the complete withdrawal of the drug that caused it. Until this point, at the stage of primary diagnosis, this diagnosis is preliminary, presumptive. To confirm it with laboratory or instrumental methods of investigation is impossible. Indirectly to help or assist with statement of the diagnosis the diary of headaches which the doctor recommends the patient to conduct can. In it, he should note the time of the onset of the headache, its nature, time, name and dose of the analgesic drug that it receives.

If the patient does not notice improvement in his condition 2 months after the abolition of analgesics, the diagnosis of "abusus headache" is doubtful and it is necessary to look for other causes of the disease.

Tactics of treatment of

Everyone who suffers from this pathology should understand that the main direction of her treatment is the complete withdrawal of the medication( if it is a non-narcotic analgesic) that caused the pain. And the sooner this happens, the higher the probability of a complete cure. If the etiologic factor is an analgesic of another group( from the above), it is important to reduce its dosage as much as possible. This is the only effective treatment. No other means will help the patient to get rid of the abusus headache if he continues to still take the drug that causes it.

The patient's condition is likely to worsen after the discontinuation of taking the analgesic: there will be withdrawal syndrome( pain will become more intense, nausea and / or vomiting may occur, the patient will become more anxious, the sleep will worsen).But after 2 weeks the number of days per month with a headache of this nature will be reduced by 2 times, and after another 14-30 days the disease will be transformed into the original form.

If the patient feels much worse on the background of abolishing the causative drug, he needs hospital treatment: infusion of detoxification solutions( reamberin, isotonic sodium chloride solution and others), sorbents, glucocorticoids( prednisolone), antiemetics( metoclopromide and so on).

Simultaneously with the cancellation of the "culprit" of the disease, the patient should be prescribed drugs for the treatment of tension or migraine headaches( of course, depending on what form of headaches he had initially).These funds of the following groups:

• antidepressants( amitriptyline, paroxetine, fluoxetine, sertraline, venlafaxine and others);
• anticonvulsant( sodium valproate, topiramate and others).

If the patient is diagnosed with anxiety or depressive disorder, this is a direct indication for the consultation of the psychiatrist and the appointment of adequate treatment, as well as psychotherapy.

Forecast of

In case of successful persistent treatment, the prognosis for recovery is favorable: the abuzus headaches disappear completely. However, more than a third of patients may be relapsed! Patients should be aware of this and strictly control the amount and dose of pain medication they take. Begin to take the "culprit" drug( if there is an acute need for it) can only after 2 months, in a minimal dosage and with a frequency of reception is not more often 1-2 times a week.

Conclusion

Abuzusnye headaches occur in people who previously suffered from migraine headaches or tension, as a result of irrational intake of pain medications. This pathology delivers patients a significant discomfort, because the pains bother them around the clock for more than 15 days a month.

The diagnosis is established retrospectively, when after the abolition of the "guilty" drug pains go away, returning to the original.

Actually, a complete refusal to take a medication that caused abusic headaches is the only effective method of treating them. This can be accompanied by a withdrawal syndrome, for the treatment of severe forms of which infusion of detoxification drugs, antiemetics, and glucocorticoid therapy are used. It is also necessary to treat primary cephalalgia, namely migraine or tension headache.

With early treatment and a positive attitude of the patient, the disease recedes, but within the next 5 years can recur.