Medication-overuse headache: similarities with drug addiction. Trends Pharmacol Sci

Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy.
Trends in Pharmacological Sciences (Impact Factor: 9.99). 03/2005; 26(2):62-8. DOI: 10.1016/
Source: PubMed

ABSTRACT Medication-overuse headache (MOH) is a clinically important entity and it is now well documented that the regular use of acute symptomatic medication by people with migraine or tension-type headache increases the risk of aggravation of the primary headache. MOH is one the most common causes of chronic migraine-like syndrome. In this article, we analyse the possible mechanisms that underlie sensitization in MOH by comparing these mechanisms with those reported for other forms of drug addiction. Moreover, the evidence for cognitive impulsivity in drug overuse in headache and in other forms of addiction associated with dysfunction of the frontostriatal system will be discussed. An integrative hypothesis for compulsive reward-seeking in MOH will be presented.

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Available from: Letizia Maria Cupini, Aug 27, 2015
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    • "Moreover, Calabresi and Cupini (2005) showed that the balance between 5-HT and dopamine systems may play a crucial role in MOH sensitization and in various forms of drugs (23) . Although this study did not find an association between TPH2 gene polymorphisms and the complication of MOH in migraine patients, it is possible that other 5-HT-related gene polymorphisms may contribute to the aggravation of migraines by the overuse of medication . "
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    ABSTRACT: Purpose: We investigated whether tryptophan hydroxylase 2 (TPH2) gene polymorphisms were involved in the aggravation of migraines due to the overuse of medication. Methods: Forty-seven migraine patients (6 males and 41 females; 36.4 10.3 years) and 22 MOH patients (1 male and 21 females; 39.6 9.9 years) who had migraines participated in this study. The genotypes for the TPH2 gene polymorphisms (rs4565946, rs4570625, and rs4341581) were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. Results: The rs4565946, rs4570625, and rs4341581 genotypes were similarly distributed between migraine patients and MOH patients. Conclusion: The results of this study showed no association between tryptophan TPH2 gene polymorphisms and the complication of MOH in patients with migraines.
    Acta neurologica Taiwanica 12/2013; 22(4):147-51.
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    • "Yet, the pathophysiology of MOH remains unclear. An integrative hypothesis for compulsive reward seeking behaviour in MOH similar to that seen with substance dependence has been proposed (Calabresi and Cupini, 2005; Fuh et al., 2005). Interestingly, MOH has been recently found associated with reversible metabolic changes in some pain processing structures and with persistent orbitofrontal hypofunction even after withdrawal of analgesics (Fumal et al., 2006). "
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    ABSTRACT: Chronic migraine (CM) is frequently associated with medication overuse headache (MOH). The endocannabinoid system plays a role in modulating pain including headache and is involved in the common neurobiological mechanism underlying drug addiction and reward system. Anandamide (AEA) and 2-arachidonoylglycerol are the most biologically active endocannabinoids, which bind to both central and peripheral cannabinoid receptors. The level of AEA in the extracellular space is controlled by cellular uptake via a specific AEA membrane transporter (AMT), followed by intracellular degradation by the enzyme AEA hydrolase (fatty acid amide hydrolase, FAAH). AMT and FAAH have also been characterized in human platelets. We assayed the activity of AMT and of FAAH in platelets isolated from four groups of subjects: MOH, CM without MOH, episodic migraine and controls. AMT and FAAH were significantly reduced in CM and MOH, compared to either controls or episodic migraine group. This latter finding was observed in both males and females with CM and MOH. Changes observed in the biochemical mechanisms degrading endogenous cannabinoids may reflect an adaptative behaviour induced by chronic headache and/or drug overuse.
    Neurobiology of Disease 06/2008; 30(2):186-9. DOI:10.1016/j.nbd.2008.01.003 · 5.20 Impact Factor
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    ABSTRACT: Chronic daily headache relates to the daily or almost daily occurrence of headache in a nonparoxysmal pattern. In this review, I discuss the presentation, development, outcome, and treatment of chronic daily headache. In the context of the development of chronic daily headache, a headache continuum is presented along with its underlying pathophysiology. The treatment section covers rebound headache, analgesic and vasoconstrictor withdrawal, and the use of long-acting opioids in intractable patients. The review concludes with a discussion of hemicrania continua, an indomethacin-responsive headache syndrome.
    The Journal of Headache and Pain 12/2003; 4(3). DOI:10.1007/s10194-003-0045-6 · 3.28 Impact Factor
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