Medication Overuse in Children and Adolescents
Current Pain and Headache Reports (Impact Factor: 2.26). 07/2014; 18(7):428. DOI: 10.1007/s11916-014-0428-1
Medication overuse is not uncommon among children and adolescents with primary headache disorders. Medication overuse in adults is associated with increased headache frequency and reduced effectiveness of acute and preventive medications. These issues probably exist in children. While withdrawal of overused medications is generally recommended, it may not result in improved headache frequency in all patients. This review summarizes what is known about predicting the response to medication withdrawal. Strategies for managing children and adolescents with medication overuse are also offered.
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ABSTRACT: SYNOPSIS 318 patients satisfying the Ad Hoc Committee's criteria for common or classical migraine were entered into an 8 week single-blind placebo recording phase to establish, by diary cards, the frequency and severity of their attacks. 176 patients completed this and had records indicating 4–8 episodes in the 8 week period, with sufficient severity to reduce activity and/or work; these patients wore randomized by a predetermined code, into three double-blinded groups: naproxen sodium 550 mg bid (60 patients), pizotyline 0.5 mg tid (59 patients), or placebo (57 patients). The patients wore followed at monthly intervals for 12 weeks, with 25 dropping out (3 on naproxen sodium, and 2 each on pizotyline and placebo because of “side effects;” the remaining 18 because of noncompliance or reasons unrelated to therapy). Approximately 25% of patients in each of the 3 groups complained of side effects. Statistical analysis showed that both naproxen sodium and pizotyline were better than placebo, and of overall equivalent (i.e. equal) efficacy in the prophylaxis of migraine. In some respects, naproxen sodium was slightly more effective than pizotyline in the first month of treatment.Headache The Journal of Head and Face Pain 12/1990; 30(11):710-5. DOI:10.1111/j.1526-4610.1990.hed3011710.x · 2.71 Impact Factor
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ABSTRACT: Naproxen sodium, a potent inhibitor of prostaglandin biosynthesis and platelet aggregation, was studied for efficacy in migraine prophylaxis in a randomized, double-blind, placebo-controlled, crossover trial. On naproxen treatment, 52% of the patients had no severe headaches, whereas 19% had no severe headaches during placebo. Naproxen sodium was much better than placebo when patients' diaries were reviewed for severity of attacks, nausea, vomiting, activity reduction, duration of headache, and decreased use of therapeutic medication. The degree of platelet inhibition did not correlate with efficacy in preventing headache. Naproxen sodium can be recommended as a drug of first choice for migraine prevention.Neurology 10/1985; 35(9):1304-10. DOI:10.1212/WNL.35.9.1304 · 8.29 Impact Factor
- Headache The Journal of Head and Face Pain 10/1985; 25(6):320-4. · 2.71 Impact Factor
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