Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Related Concept Videos

Pharmaceutical Poisoning: Treatment Strategies

Pharmaceutical Poisoning: Treatment Strategies

Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...

Enhanced Elimination of Poison

Enhanced Elimination of Poison

Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...

Toxidromes: Clinical Features

Toxidromes: Clinical Features

Toxidromes are specific patterns of symptoms resulting from toxic substance exposure. They help in the identification and treatment of poisoning. The symptoms of each toxidrome group indicate poisoning by a certain class of chemicals or drugs.1. Sympathomimetic: Stimulates the sympathetic nervous system. Symptoms include agitation, increased heart rate (HR), blood pressure (BP), respiratory rate (RR), temperature, and pupil size. Drugs like cocaine and amphetamines, along with tremors and...

Drug Abuse and Addiction: Pharmacological Phenomena

Drug Abuse and Addiction: Pharmacological Phenomena

Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not necessarily...

Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration

Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration

Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...

Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics

Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics

Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by anesthetizing...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Preventive migraine treatment with eptinezumab reduced acute headache medication and headache frequency to below diagnostic thresholds in patients with chronic migraine and medication-overuse headache.

Headache·2021

Same author

Amplatzer Amulet Left Atrial Appendage Occluder Versus Watchman Device for Stroke Prophylaxis (Amulet IDE): A Randomized, Controlled Trial.

Circulation·2021

Same author

Doubtful use of placebo following placebo in recent controlled trials of lasmiditan and ubrogepant for the treatment of migraine attacks.

Cephalalgia : an international journal of headache·2021

Same author

Changes in anticoagulant prescription patterns over time for patients with atrial fibrillation around the world.

Journal of arrhythmia·2021

Same author

MMW Fortschritte der Medizin·2021

Same author

COVID-19 Vaccine-Associated Cerebral Venous Thrombosis in Germany.

Annals of neurology·2021

Search research articles

Related Experiment Video

Updated: May 27, 2026

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

Published on: April 23, 2019

Detoxification for medication overuse headache is not necessary.

Hans-Christoph Diener¹

¹University Hospital Essen, Germany. h.diener@uni-essen.de

Cephalalgia : an International Journal of Headache

|December 1, 2011

Summary

Patients with chronic migraine and medication overuse can benefit from preventive treatments like topiramate or onabotulinum toxin A, challenging traditional withdrawal protocols. Early intervention with these therapies can reduce migraine frequency and acute medication use.

More Related Videos

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

Published on: June 2, 2014

A General Method for Evaluating Deep Brain Stimulation Effects on Intravenous Methamphetamine Self-Administration

A General Method for Evaluating Deep Brain Stimulation Effects on Intravenous Methamphetamine Self-Administration

Published on: January 22, 2016

Related Experiment Videos

Last Updated: May 27, 2026

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

Published on: April 23, 2019

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

Published on: June 2, 2014

A General Method for Evaluating Deep Brain Stimulation Effects on Intravenous Methamphetamine Self-Administration

A General Method for Evaluating Deep Brain Stimulation Effects on Intravenous Methamphetamine Self-Administration

Published on: January 22, 2016

Area of Science:

Neurology
Pharmacology
Clinical Medicine

Background:

Traditional management for chronic migraine with medication overuse involves acute medication withdrawal before preventive therapy.
This approach is based on the assumption that these patients are resistant to preventive treatments.
Recent randomized trials contradict this, showing significant patient response to specific preventive therapies.

Purpose of the Study:

To challenge the conventional recommendation of medication withdrawal for chronic migraine patients.
To highlight the efficacy of specific preventive treatments in patients with medication overuse.
To propose an updated treatment algorithm for chronic migraine with medication overuse.

Main Methods:

Review of four randomized controlled trials investigating topiramate and onabotulinum toxin A in chronic migraine with medication overuse.
Analysis of treatment outcomes, including reduction in migraine days and acute medication intake.
Development of a proposed treatment algorithm based on study findings.

Main Results:

Approximately 50% of patients with chronic migraine and medication overuse responded positively to topiramate or onabotulinum toxin A.
These treatments led to a reduction in both migraine frequency and the need for acute medication.
The findings suggest that preventive therapies can be effective without prior withdrawal.

Conclusions:

Patients with chronic migraine and medication overuse may not require mandatory acute medication withdrawal before initiating preventive therapy.
A proposed approach involves patient education on medication overuse, followed by topiramate or onabotulinum toxin A with behavioral support.
Withdrawal therapy should be considered only if the initial approach proves unsuccessful.