Related Experiment Video
Updated: Apr 26, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Nasal decongestant and chronic headache: a case of naphazoline overuse headache?
Cherubino Di Lorenzo1, Gianluca Coppola2, Valeria La Salvia3
1Don Carlo Gnocchi Onlus Foundation, Milan, 20100, Italy.
Background:
Chronic headache is an incapacitating condition afflicting patients at least for 15 days per month. In the most cases it is developed as a consequence of an excessive use of symptomatic drugs.
Case:
Here we report the case of a 34 year-old man suffering from chronic headache possibly related to the overuse of naphazoline nitrate nasal decongestant, used to treat a supposed chronic sinusitis. However, the patient did not suffer from sinusitis, but from a medication overuse headache (ICHD-II 8.3; ICD-10 44.41) that appeared to be due to excessive use of naphazoline.
Conclusion:
The use of naphazoline nitrate may result in an analgesic effect upon first use, through activation of adrenergic and opioidergic systems, followed by a pro-migraine effect via a late induction of an inflammatory cascade, modulated by nitric oxide and arachidonic acid. The observation that naphazoline detoxification relieved the patient's headache, indicates that prolonged use of naphazoline may cause chronic headaches. Therefore, physicians should ask for details on the use of nasal decongestants in patients complaining of chronic headache, as they could potentially be suffering from a medication-overuse headache.
Related Concept Videos
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
Phenothiazines, such as prochlorperazine...
Upper Respiratory Drugs: Decongestants
Most decongestants are readily available over-the-counter in...
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
Upper Respiratory Drugs: First and Second-Generation Antihistamines
Histamine binds to specific receptor sites, known as H1 receptors, on tissue cells, triggering inflammation and swelling. Antihistamines combat these effects by competing with histamine for these receptor sites. By...
Narcolepsy
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

