药物过度使用头痛:更新的综述和管理临床建议
Megan A Hird1, Claire H Sandoe2,3
1Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada.
Current neurology and neuroscience reports
|June 4, 2023
概括
药物过度使用头痛 (MOH) 影响了许多主要头痛疾病患者. 管理包括戒药,预防疗法和以患者为中心的护理.
科学领域:
- 神经学 神经学
- 临床医学 临床医学
背景情况:
- 药物过度使用头痛 (MOH) 是患有初级头痛疾病的患者常见的并发症.
- 了解它的流行病学和风险因素对于有效管理至关重要.
研究的目的:
- 提供卫生部流行病学,风险因素和当前治疗策略的最新审查.
- 为卫生部的临床管理提供建议.
主要方法:
- 审查最近的大型临床试验和新出现的证据.
- 分析预防性疗法和管理方法.
主要成果:
- MOH的患病率在0.5%至7.2%之间,风险因素包括女性性别,较低的社会经济地位,精神疾病和物质使用障碍.
- 预防性疗法,包括抗CGRP mAbs,candesartan,topiramate,amitriptyline和onabotulinumtoxinA,得到了最近的临床试验的支持.
- 有效的MOH管理需要一个多方面的,以患者为中心的方法.
结论:
- 一个综合战略,结合患者教育,行为干预,药物戒断和预防性治疗,对于管理MOH至关重要.
- 新兴的治疗方法显示出希望,加强了更新临床指导方针的需要.
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