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Chronic Migraine with Medication Overuse: Clinical Pattern and Evolution from a Retrospective Cohort in Seville, Spain

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Abstract

Chronic migraine (CM) with medication overuse (MO) develops in patients with a pre-existing primary headache after a regular overuse of symptomatic medication. In these patients, headache crisis may occur together with other painful pathologies which can increase the frequency and intensity of the pain episodes. Such comorbidities need to be assessed as they influence the clinical evolution of the patients. A cohort of 102 patients (89 women and 13 men) with a diagnosis of chronic migraine (CM) with medication overuse (MO) was retrospectively analysed. Patients enrolled in the study were actively followed up 23 months in the Neurology Service of the University Hospital Virgen del Rocío in Seville, Spain. We observed that most of the patients overused multiple symptomatic drugs (34.3%) and NSAIDs (26.5%). In this cohort, the most effective treatments were topiramate and the combination of multiple prophylactic drugs with an effectiveness of 41.6% and 53.8%, respectively, at the end of the study. We observed the ratio of patients reducing their headache crisis was significantly higher among patients abandoning their medication overuse. Detoxification, or withdrawal of medication overuse, is linked to the reduction of the frequency and intensity of 50% or more of the headache crisis in these patients.

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Data Availability

The datasets of the current study are not available for reasons of data protection of the hospital where it has been conducted under study.

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Acknowledgements

The authors would like to thank the participants of the study for their cooperation.

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Authors and Affiliations

  1. Neurology Service, University Hospital Virgen del Rocío, Seville, Spain

    María del Valle López Martínez & María Dolores Jiménez Hernández

  2. Health Science Technologies Research Group, Biotechnology-BV ETSIAAB Department, Universidad Politécnica de Madrid, Madrid, Spain

    Javier Pareja Román & María del Carmen Ramírez-Castillejo

  3. Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Madrid, Spain

    Ceferino Maestu Unturbe

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  1. María del Valle López Martínez
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Correspondence to María del Valle López Martínez.

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Ethics Approval and Consent to Participate

On January 13, 2016, Royal Decree 1090/2015 of December 4, which regulates clinical trials with drugs, the Ethics Committees for Drug Research and the Spanish Registry of Clinical Studies entered into force. This regulation aims to adapt to Regulation (EU) 536/2014 of the European Parliament and of the Council of April 16, 2014, on clinical trials of medicines for human use, which will be fully applicable in October 2018. In order to be able to continue carrying out the evaluative activity that it carried out up to that moment on clinical trials, it adhered to the Memorandum of Collaboration with the Spanish Agency for Medicines and Health Products (AEMPS) to act as the Research Ethics Committee with medicines (CEIm).

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López Martínez, M., Pareja Román, J., Jiménez Hernández, M.D. et al. Chronic Migraine with Medication Overuse: Clinical Pattern and Evolution from a Retrospective Cohort in Seville, Spain. SN Compr. Clin. Med. 2, 1514–1525 (2020). https://doi.org/10.1007/s42399-020-00424-8

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