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Nervenheilkunde 2009; 28(06): 373-377
DOI: 10.1055/s-0038-1628648
Thema zum Schwerpunkt
Schattauer GmbH

Medikamentenübergebrauch als Risikofaktor der Kopfschmerzchronifizierung

Medication overuse is a risk factor for chronification of headache
Z. Katsarava
1   Neurologische Klinik und Westdeutsches Kopfschmerzzentrum, Universitätsklinikum Essen
,
T. Zwarg
1   Neurologische Klinik und Westdeutsches Kopfschmerzzentrum, Universitätsklinikum Essen
,
T.-M. Wallasch
2   Klinik für Interdisziplinäre Schmerztherapie am Sankt Gertrauden Krankenhaus Berlin, Kopf-Schmerzzentrum, Lehrkrankenhaus der Charité
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Publikationsverlauf

Eingegangen am: 01. September 2008

angenommen am: 23. September 2008

Publikationsdatum:
24. Januar 2018 (online)

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Zusammenfassung

Die internationale Kopfschmerzgesellschaft definiert einen Kopfschmerz als chronisch, sobald er an mehr als 15 Tagen pro Monat auftritt. Die überwiegende Mehrheit der Patienten mit chronischen Kopfschmerzen leidet an medikamenteninduziertem Kopfschmerz, chronischer Migräne oder chronischem Spannungskopfschmerz. Häufige Einnahme (Übergebrauch) von Schmerzund/oder Migränemitteln ist wahrscheinlich der wichtigste Faktor, der zu einer Entwicklung des Medikamenteninduzierten Kopfschmerzes führt (MIKS). Die Prävalenz des MIKS beträgt etwa 1% weltweit mit steigender Tendenz. Viele wichtige Studien zum MIKS wurden veröffentlicht. Einige beschäftigten sich mit der Pathophysiologie, andere fokussierten auf die Evaluation von Risikofaktoren. Die Internationale Kopfschmerzgesellschaft (IHS) überarbeitete ihre Kriterien zur Klassifikation des MIKS. Einige große populationsbasierte longitudinale Studien bestätigten eindeutig, dass Übergebrauch jeglicher akuter Schmerzoder Migränemittel der Hauptrisikofaktor zur Entwicklung chronischer Kopfschmerzen ist. Die Behandlung eines MIKS bleibt schwierig. Das einzige erfolgreiche Konzept ist, die eingenommenen Medikamente konsequent abzusetzen.

Summary

The international headache society defines headache as chronic if it occurs on more than 15 days per month. The vast majority of patients suffering from chronic headache have medication overuse headache, chronic migraine or chronic tension-type headache. Frequent intake (overuse) of acute headache drugs is probably the most important risk factor leading do the development of medication overuse headache (MOH). The prevalence of MOH reaches approximately 1% of the world’s population and shows an increasing trend. Many important studies on medication overuse headache have been published. Some of them investigated the pathophysiology of headache chronification others focused on the evaluation of risk factors. The IHS revised its classification criteria on MOH. Several large population based longitudinal studies clearly demonstrated that overuse of any kind of acute headache medication is the main risk factor leading to the development of chronic headache. Management of MOH remains difficult. The only effective treatment concept remains consequent withdrawal therapy.

Schlüsselwörter

Medikamentenübergebrauch - chronische Kopfschmerzen - Migräne - Spannungskopfschmerz

Keywords

Medication overuse - chronic headache - migraine - tension-type headache
 

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