It's also interesting to note that another study found that of patients treated with daily analgesics (62.5% used opioids) for conditions such as rheumatoid arthritis, those with Migraines developed TM at a higher-than-expected rate, indicating that even when Migraineurs are taking medications for conditions other than Migraine, TM and medication overuse headache can develop.
The final paragraph of the journal article is is so clear that it bears repeating:
"These findings have potential implications for clinical practice. We suggest that use of opiates and barbiturates should be limited and well monitored in Migraineurs. We also suggest particular caution in using opiates to treat Migraine in men. Caution is also advised in individuals with high frequency of headaches [Migraines] using any medication."
This research supports the importance of Migraine management and prevention. Trigger identification and management and an effective preventive regimen are integral to reducing the number of days per month that acute medications (taken when a Migraine occurs) are needed.
If you use opioids (such as Percocet, Vicodin, Dilaudud, etc.) or barbiturates (such as Fiorinal, Fioricet) for your Migraines, this information about increased risk of TM is not a reason to panic or suffer through your pain without medications. Instead, work with your doctor to decrease the number of Migraines you have, thus decreasing your need for these medications.
If you use triptans or NSADIs, the same applies. Work with your doctor to reduce the number of days you need them.
If NSAIDs have been prescribed for you for Migraine prevention, please bring this study to the attention of your doctor and discuss other preventive measures.
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Resources:
1 Bigal, Marcelo E., MD, PhD; Serrano, Daniel, MA; Buse, Dawn, PhD; Ann Scher, PhD; Stewart, Walter F., PhD; Lipton, Richard B., MD. "Acute Migraine Medications and Evolution From Episodic to Chronic Migraine: A Longitudinal Population-Based Study." Headache 2008;48:1157-1168.
2 Harold G. Wolff Lecture Award Presentation. Marcelo E. Bigal, MD, PhD. "Acute Migraine Medications and Evolution From Episodic to Chronic Migraine: A Longitudinal Population-Based Study: A Longitudinal Population-Based Study." American Headache Society 50th Annual Scientific Meeting. Boston. June 27, 2008.
3 Neergaard, Lauran. "Avoiding the painkiller-overuse rut in migraines." Reuters. Washington. December 22,2008.
© Teri Robert, 2009.
Last updated January 3, 2009.
