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Related Experiment Videos

[Primary chronic daily headache: a report on 52 cases]

C da C Jevoux1, P F Moreira Filho, J A de Souza

  • 1Hospital Universitário Antonio Pedro da Universidade Federal Fluminense (HUAP/UFF), Brasil.

Arquivos De Neuro-Psiquiatria
|August 1, 1998
PubMed
Summary

Treating chronic daily headache (CDH) with amitriptyline and propranolol, alongside stopping symptomatic medication, effectively reduced headache frequency in most patients. Long-term benefits were observed, with persistent drug overuse linked to treatment failure.

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Area of Science:

  • Neurology
  • Clinical Medicine

Context:

  • Chronic daily headache (CDH) affects a significant patient population.
  • Diagnosis of CDH includes transformed migraine, chronic tension-type headache, and new daily persistent headache.
  • Drug-induced headache is a common comorbidity in CDH patients due to excessive symptomatic medication use.

Purpose:

  • To evaluate the efficacy of a treatment regimen for chronic daily headache (CDH).
  • To assess the impact of amitriptyline and propranolol combined with symptomatic medication withdrawal on CDH frequency.
  • To identify factors associated with treatment success or failure in CDH patients.

Summary:

  • A study of 52 patients with chronic daily headache (CDH) identified transformed migraine (75%), chronic tension-type headache (21.1%), and new daily persistent headache (3.9%) as primary types.

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  • Thirty-four patients had drug-induced headache from excessive symptomatic medication use.
  • Treatment with escalating doses of amitriptyline, with or without propranolol, and cessation of symptomatic drugs reduced headache frequency in most CDH patients.
  • Beneficial effects persisted for up to six months.
  • Treatment failure was statistically associated with the continued overuse of symptomatic medications.

    • Impact:

    • The findings suggest a viable treatment strategy for managing chronic daily headache (CDH), particularly when drug-induced headache is present.
    • Identifying the link between symptomatic medication overuse and treatment failure highlights a critical factor for clinical intervention.
    • This research provides evidence for the long-term effectiveness of a specific therapeutic approach in reducing headache burden.