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Disability in chronic migraine patients with medication overuse: treatment effects at 1-year follow-up.
Headache. 2004 Jul-Aug; 44(7):678-83.H

Abstract

OBJECTIVE

To determine (1) the clinical course of a sample of chronic migraine patients with drug overuse 6 and 12 months following in-patient treatment and (2) whether functional impairment, assessed by the Migraine Disability Assessment (MIDAS) questionnaire, improved upon treatment.

BACKGROUND

Patients with chronic migraine and medication overuse are particularly difficult to treat (prophylactic medications that otherwise are effective become ineffective; discontinuation of the offending medication can lead to withdrawal headache; physical and emotional dependence can be present, as well as increased psychological involvement; initial treatment gains can be difficult to maintain).

METHODS

Of the 106 patients meeting criteria for chronic migraine with medication overuse, 84 went on to complete a structured in-patient treatment, consisting of medication withdrawal and then prophylactic treatment.

RESULTS

As a group, the patients were improved at both 6- and 12-month follow-up, with respect to two headache parameters (frequency and medication use) and three measures of functional impact extracted from the MIDAS questionnaire (Total Score, Headache Frequency, and Headache Intensity).

CONCLUSION

Chronic migraine accompanied with medication overuse led to the considerable disability prior to treatment. However, notable improvement occurred coincident with the treatment. This suggests that successful treatment has more wide-ranging positive benefits beyond mere symptom reduction. To our knowledge, this is the first investigation where the MIDAS questionnaire has been used prospectively as an outcome measure in patients with chronic migraine and medication overuse to assess disability subsequent to a semi-standardized treatment program.

Authors+Show Affiliations

Neurological Institute "C.Besta," Milan, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15209690

Citation

Grazzi, Licia, et al. "Disability in Chronic Migraine Patients With Medication Overuse: Treatment Effects at 1-year Follow-up." Headache, vol. 44, no. 7, 2004, pp. 678-83.
Grazzi L, Andrasik F, D'Amico D, et al. Disability in chronic migraine patients with medication overuse: treatment effects at 1-year follow-up. Headache. 2004;44(7):678-83.
Grazzi, L., Andrasik, F., D'Amico, D., Usai, S., Kass, S., & Bussone, G. (2004). Disability in chronic migraine patients with medication overuse: treatment effects at 1-year follow-up. Headache, 44(7), 678-83.
Grazzi L, et al. Disability in Chronic Migraine Patients With Medication Overuse: Treatment Effects at 1-year Follow-up. Headache. 2004 Jul-Aug;44(7):678-83. PubMed PMID: 15209690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disability in chronic migraine patients with medication overuse: treatment effects at 1-year follow-up. AU - Grazzi,Licia, AU - Andrasik,Frank, AU - D'Amico,Domenico, AU - Usai,Susanna, AU - Kass,Steven, AU - Bussone,Gennaro, PY - 2004/6/24/pubmed PY - 2004/12/22/medline PY - 2004/6/24/entrez SP - 678 EP - 83 JF - Headache JO - Headache VL - 44 IS - 7 N2 - OBJECTIVE: To determine (1) the clinical course of a sample of chronic migraine patients with drug overuse 6 and 12 months following in-patient treatment and (2) whether functional impairment, assessed by the Migraine Disability Assessment (MIDAS) questionnaire, improved upon treatment. BACKGROUND: Patients with chronic migraine and medication overuse are particularly difficult to treat (prophylactic medications that otherwise are effective become ineffective; discontinuation of the offending medication can lead to withdrawal headache; physical and emotional dependence can be present, as well as increased psychological involvement; initial treatment gains can be difficult to maintain). METHODS: Of the 106 patients meeting criteria for chronic migraine with medication overuse, 84 went on to complete a structured in-patient treatment, consisting of medication withdrawal and then prophylactic treatment. RESULTS: As a group, the patients were improved at both 6- and 12-month follow-up, with respect to two headache parameters (frequency and medication use) and three measures of functional impact extracted from the MIDAS questionnaire (Total Score, Headache Frequency, and Headache Intensity). CONCLUSION: Chronic migraine accompanied with medication overuse led to the considerable disability prior to treatment. However, notable improvement occurred coincident with the treatment. This suggests that successful treatment has more wide-ranging positive benefits beyond mere symptom reduction. To our knowledge, this is the first investigation where the MIDAS questionnaire has been used prospectively as an outcome measure in patients with chronic migraine and medication overuse to assess disability subsequent to a semi-standardized treatment program. SN - 0017-8748 UR - https://www.unboundmedicine.com/medline/citation/15209690/Disability_in_chronic_migraine_patients_with_medication_overuse:_treatment_effects_at_1_year_follow_up_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0017-8748&date=2004&volume=44&issue=7&spage=678 DB - PRIME DP - Unbound Medicine ER -