Skip to main content
SpringerLink
Log in

Medical Interventions for Migraine That Has Become Difficult to Treat

  • Reference work entry
Handbook of Headache

Abstract

Migraine is an episodic painful disorder which can gradually chronify, and is among the most common neurological diseases in clinical practice. Such process is often accompanied by the appearance of acute drugs overuse. Chronic migraine (CM) constitutes migraine’s natural evolution in its chronic form and involves headache frequency of 15 days/month, with features similar to those of migraine attacks. Migraine given by drugs overuse, defined by ICDH-II in 2004 (and revised in 2005) as MOH, represents a common and debilitating disorder, which can be defined as generation, perpetuation and persistence of intense chronic migraine caused by the frequent and excessive use of (symptomatic) drugs for at least 3 months, for a certain number of days per month, giving an immediate relief. Migraine’s progression from an episodic to a chronic form is generally influenced by baseline headache frequency, inappropriate use of rescue self-medication, absence of referral to headache centers during the worsening period in terms of headache days frequency, as well as by lack of education in avoiding trigger factors or inadequate lifestyle rhythms (fasting, sleepiness). In MOH sufferers, the only treatment of choice is represented by drug withdrawal. Successful detoxification is necessary to ensure improvement in the headache status when treating patients who overuse acute medications. Possible therapeutic agents in CM re-prophylaxis after detoxification are OnabotulinumtoxinA and Topiramate. The future in relapse prevention of CM complicated by MOH consists in considering how drugs currently used, such as triptans and emerging therapies, present responsivity profiles related to well-defined genetic polymorphisms.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 279.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Akerman S, Goadsby PJ (2005) Topiramate inhibits cortical spreading depression in rat and cat: impact in migraine aura. NeuroReport 16:1383–1387

    Article  PubMed  CAS  Google Scholar 

  • Allena M, Katsarava Z, Nappi G, the COMOESTAS Consortium (2009) From drug-induced headache to medication overuse headache. A short epidemiological review, with a focus on Latin American countries. J Headache Pain 10:71–76

    Article  PubMed  Google Scholar 

  • Altieri M, Di Giambattista R, Di Clemente L, Fagiolo D, Tarolla E, Mercurio A, Vicenzini E, Tarsitani L, Lenzi GL, Biondi M, Di Piero V (2009) Combined pharmacological and short-term psychodynamic psychotherapy for probable medication overuse headache: a pilot study. Cephalalgia 29(3):293–299

    Article  PubMed  CAS  Google Scholar 

  • Aoki KR (2003) Evidence for antinociceptive activity of botulinum toxin type A in pain management. Headache 43:S9–S15

    Article  PubMed  Google Scholar 

  • Aurora SK, Dodick DW, Turkel CC, DeGryse RE, Silberstein SD, Lipton RB, Diener HC, Brin MF, on behalf of PREEMPT 1 Trial (2010) OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 1 trial. Cephalalgia 30:793–803

    Article  PubMed  CAS  Google Scholar 

  • Bigal ME, Lipton RB (2008a) Concepts and mechanisms of migraine chronification. Headache 48:7–15

    Article  PubMed  Google Scholar 

  • Bigal ME, Lipton RB (2008b) Excessive acute migraine medication use and migraine progression. Neurology 71(22):1821–1828

    Article  PubMed  CAS  Google Scholar 

  • Bigal ME, Lipton RB (2009a) Overuse of acute migraine medications and migraine chronification. Curr Pain Headache Rep 13(4):301–307

    Article  PubMed  Google Scholar 

  • Bigal ME, Lipton RB (2009b) What predicts the change from episodic to chronic migraine? Curr Opin Neurol 22:269–276

    Article  PubMed  Google Scholar 

  • Bigal ME, Serrano D, Buse D, Scher A, Stewart WF, Lipton RB (2008) Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population-based study. Headache 48(8):1157–1168

    Article  PubMed  Google Scholar 

  • Blumenfeld A, Tischio M (2003) Center of excellence for headache care: group model at Kaiser Permanente. Headache 43(5):431–440

    Article  PubMed  Google Scholar 

  • Bøe MG, Mygland A, Salvesen R (2007) Prednisolone does not reduce withdrawal headache: a randomized, double-blind study. Neurology 69(1):26–31

    Article  PubMed  Google Scholar 

  • Buse DC, Marcia FT, Rupnow FT, Lipton RB (2009a) Assessing and managing all aspects of migraine: migraine attacks, migraine related functional impairment, common comorbidities, and quality of life. Mayo Clin Proc 84:422–435

    Article  PubMed  Google Scholar 

  • Buse DC, Rupnow MF, Lipton RB (2009b) Assessing and managing all aspects of migraine: migraine attacks, migraine-related functional impairment, common comorbidities, and quality of life. Mayo Clin Proc 84(5):422–435

    Article  PubMed  Google Scholar 

  • Cady R, Schreiber C (2008) Botulinum toxin type A as migraine preventive treatment in patients previously failing oral prophylactic treatment due to compliance issues. Headache 48(6):900–913

    Article  PubMed  Google Scholar 

  • Castillo J, Muñoz P, Guitera V, Pascual J (1999) Kaplan award 1998: epidemiology of chronic daily headache in the general population. Headache 39:190–196

    Article  PubMed  CAS  Google Scholar 

  • Cupini LM, Calabresi P (2005) Medication-overuse headache: pathophysiological insights. J Headache Pain 6(4):199–202

    Article  PubMed  Google Scholar 

  • D'Amico D, Solari A, Usai S, Santoro P, Bernardoni P, Frediani F, De Marco R, Massetto N, Bussone G, Progetto Cefalee Lombardia Group (2006) Improvement in quality of life and activity limitations in migraine patients after prophylaxis. A prospective longitudinal multicentre study. Cephalalgia 26(6):691–696

    Article  PubMed  Google Scholar 

  • De Filippis S, Salvatori E, Coloprisco G, Martelletti P (2006) Chronic daily headache: management and rehabilitation. Clin Ter 157(2):153–157

    PubMed  Google Scholar 

  • De Filippis S, Salvatori E, Farinelli I, Coloprisco G, Martelletti P (2007) Chronic daily headache and medication overuse headache: clinical read-outs and rehabilitation procedures. Clin Ter 158(4):343–347

    PubMed  Google Scholar 

  • Di Lorenzo C, Di Lorenzo G, Sances G et al (2009) Drug consumption in medication overuse headache is influenced by brain derived neurotrophic factor Val66Met polymorphism. J Headache Pain 10:349–355

    Article  PubMed  Google Scholar 

  • Diener HC, Limmroth V (2004) Medication-overuse headache: a worldwide problem. Lancet Neurol 3:475–483

    Article  PubMed  Google Scholar 

  • Diener HC, Bussone G, Van Oene JC et al (2007) Topiramate reduces headache days in chronic migraine: a randomized, double- blind, placebo-controlled study. Cephalalgia 27:814–823

    Article  PubMed  Google Scholar 

  • Diener HC, Dodick DW, Aurora SK, Turkel CC, DeGryse RE, Lipton RB, Silberstein SD, Brin MF, on behalf of the PREEMPT 2 Chronic Migraine Study Group (2010) OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 2 trial. Cephalalgia 30:804–814

    Article  PubMed  CAS  Google Scholar 

  • Dodick DW, Turkel CC, DeGryse RE, Aurora SK, Silberstein SD, Lipton RB, Diener H-C, Brin MF, on behalf of the PREEMPT Chronic Migraine Study Group (2010) OnabotulinumtoxinA for treatment of chronic migraine: pooled a results from the doubleblind, randomized, placebo-controlled phases of the PREEMPT Clinical Program. Headache 50:921–936

    Article  PubMed  Google Scholar 

  • Durham PL, Cady R, Cady R (2004) Regulation of calcitonin gene-related peptide secretion from trigeminal nerve cells by botulinum toxin type A: implications for migraine therapy. Headache 44:35–43

    Article  PubMed  Google Scholar 

  • Evers S, Marziniak M (2010) Clinical features, pathophysiology, and treatment of medication overuse headache. Lancet Neurol 9:391–401

    Article  PubMed  Google Scholar 

  • Farinelli I, Coloprisco G, De Filippis S, Martelletti P (2006) Long-term benefits of botulinum toxin type A (Botox) in chronic daily headache: a five-year long experience. J Headache Pain 7:407–412

    Article  PubMed  CAS  Google Scholar 

  • Farinelli I, De Filippis S, Coloprisco G, Missori S, Martelletti P (2009) Future drugs for migraine. Int Emerg Med 4:367–373

    Article  Google Scholar 

  • Farinelli I, Dionisi I, Martelletti P (2010) Rehabilitating chronic migraine complicated by medication overuse headaches: how we can prevent migraine relapse? Int Emerg Med 6(1):23–28

    Article  Google Scholar 

  • Freitag FG (2007) The cycle of migraine: patients' quality of life during and between migraine attacks. Clin Ther 29(5):939–949

    Article  PubMed  Google Scholar 

  • Gentile G, Borro M, Lala N, Missori S, Simmaco M, Martelletti P (2010a) Genetic polymorphisms related to efficacy and overuse of triptans in chronic migraine. J Headache Pain 11(5):431–435

    Article  PubMed  CAS  Google Scholar 

  • Gentile G, Missori S, Borro M, Sebastianelli A, Simmaco M, Martelletti P (2010b) Frequencies of genetic polymorphisms related to triptans metabolism in chronic migraine. J Headache Pain 11:151–156

    Article  PubMed  CAS  Google Scholar 

  • Göbel H (2004) Botulinum toxin in migraine prophylaxis. J Neurol 251(Suppl 1):I8–I11

    PubMed  Google Scholar 

  • Grande RB, Aaseth K, Benth JŠ, Lundqvist C, Russell MB (2010) Reduction in medication-overuse headache after short information. The Akershus study of chronic headache. Eur J Neurol 18:129–137

    Article  Google Scholar 

  • Hagen K, Albretsen C, Vilming ST, Salvesen R, Grønning M, Helde G, Gravdahl G, Zwart JA, Stovner LJ (2009) Management of medication overuse headache: 1-year randomized multicentre open-label trial. Cephalalgia 29(2):221–232

    Article  PubMed  CAS  Google Scholar 

  • Hagen K, Jensen R, Bøe MG, Stovner LJ (2010) Medication overuse headache: a critical review of end points in recent followup studies. J Headache Pain 11(5):373–377

    Article  PubMed  Google Scholar 

  • Headache Classification Committee, Olesen J, Bousser MG, Diener HC, Dodick D, First M, Goadsby PJ, Göbel H, Lainez MJ, Lance JW, Lipton RB, Nappi G, Sakai F, Schoenen J, Silberstein SD, Steiner TJ (2006) New appendix criteria open for a broader concept of chronic migraine. Cephalalgia 26:742–746

    Article  PubMed  CAS  Google Scholar 

  • Katsarava Z, Schneeweiss S, Kurth T et al (2004) Incidence and predictors for chronicity of headache in patients with episodic migraine. Neurology 62:788–790

    PubMed  CAS  Google Scholar 

  • Katsarava Z, Muessig M, Dzagnidze A, Fritsche G, Diener HC, Limmroth V (2005) Medication overuse headache: rates and predictors for relapse in a 4-year prospective study. Cephalalgia 25:12–15

    Article  PubMed  CAS  Google Scholar 

  • Krymchantowski AV, Barbosa JS (2000) Prednisone as initial treatment of analgesic-induced daily headache. Cephalalgia 20:107–113

    Article  PubMed  CAS  Google Scholar 

  • Krymchantowski AV, Moreira PF (2003) Out-patient detoxification in chronic migraine: comparison of strategies. Cephalalgia 23(10):982–993

    Article  PubMed  CAS  Google Scholar 

  • Láinez MJ (2009) The effect of migraine prophylaxis on migraine-related resource use and productivity. CNS Drugs 23(9):727–738

    Article  PubMed  Google Scholar 

  • Láinez MJ, Freitag FG, Pfeil J, Ascher S, Olson WH, Schwalen S (2007) Time course of adverse events most commonly associated with topiramate for migraine prevention. Eur J Neurol 14:900–906

    Article  PubMed  Google Scholar 

  • Lake AE 3rd (2006) Medication overuse headache: biobehavioral issues and solutions. Headache 46(Suppl 3):S88–S97

    Article  PubMed  Google Scholar 

  • Lipton RB (2009) Tracing transformation: chronic migraine classification, progression, and epidemiology. Neurology 72(5 Suppl):S3–S7

    Article  PubMed  Google Scholar 

  • Lovell BV, Marmura MJ (2010) New therapeutic developments in chronic migraine. Curr Opin Neurol 23:254–258

    Article  PubMed  CAS  Google Scholar 

  • Lundqvist C, Benth JS, Grande RB, Aaseth K, Russell MB (2010) An adapted Severity of Dependence Scale is valid for the detection of medication overuse: the Akershus study of chronic headache. Eur J Neurol. doi:10.1111/j.1468-1331.2010.03202.x

    PubMed  Google Scholar 

  • MacGregor EA, Brandes J, Eikermann A, Giammarco R (2004) Impact of migraine on patients and their families: the Migraine and Zolmitriptan Evaluation (MAZE) survey– Phase III. Curr Med Res Opin 20(7):1143–1150

    Article  PubMed  CAS  Google Scholar 

  • Matchar DB, Harpole L, Samsa GP, Jurgelski A, Lipton RB, Silberstein SD, Young W, Kori S, Blumenfeld A (2008) The headache management trial: a randomized study of coordinated care. Headache 48(9):1294–1310

    Article  PubMed  Google Scholar 

  • Mathew NT, Farhan AJ (2009) A double-blind comparison of OnabotulinumtoxinA (BOTOX®) and Topiramate (TOPAMAX®) for the prophylactic treatment of chronic migraine: a pilot study. Headache 49:1466–1478

    Article  PubMed  Google Scholar 

  • Negro A, D’Alonzo L, Martelletti P (2010) Chronic migraine: comorbidities, risk factors, and rehabilitation. Intern Emerg Med 5(Suppl 1):S13–S19

    Article  PubMed  Google Scholar 

  • Obermann M, Katsarava Z (2007) Management of medication overuse headache. Expert Rev Neurother 7:1145–1155

    Article  PubMed  CAS  Google Scholar 

  • Paemeleire K, Crevits L, Goadsby PJ, Kaube H (2006) Practical management of medication-overuse headache. Acta Neurol Belg 106:43–51

    PubMed  Google Scholar 

  • Pageler L, Katsarava Z, Diener HC, Limmroth V (2008) Prednisone versus placebo in withdrawal therapy following medication overuse headache. Cephalalgia 28:152–156

    PubMed  CAS  Google Scholar 

  • Pompili M, Di Cosimo D, Innamorati M, Lester D, Tatarelli R, Martelletti P (2009) Psychiatric comorbidity in patients with chronic daily headache and migraine: a selective overview including personality traits and suicide risk. J Headache Pain 10:283–290

    Article  PubMed  Google Scholar 

  • Pompili M, Serafini G, Di Cosimo D, Innamorati M, Lester D, Forte D, Girardi N, De Filippis S, Tatarelli R, Martelletti P (2010) Psychiatric comorbidity and suicide risk in patients with chronic migraine. Neuropsychiatr Dis Treat 6:81–91

    Article  PubMed  Google Scholar 

  • Radat F, Creac'h C, Guegan-Massardier E, Mick G, Guy N, Fabre N, Giraud P, Nachit-Ouinekh F, Lantéri-Minet M (2008) Behavioral dependence in patients with medication overuse headache: a cross-sectional study in consulting patients using the DSM-IV criteria. Headache 48(7):1026–1036

    Article  PubMed  Google Scholar 

  • Rossi P, Di Lorenzo C, Faroni J, Cesarino F, Nappi G (2006) Advice alone vs. structured detoxification programmes for medication overuse headache: a prospective, randomized, open-label trial in transformed migraine patients with low medical needs. Cephalalgia 26(9):1097–1105

    Article  PubMed  CAS  Google Scholar 

  • Rossi P, Jensen R, Nappi G, Allena M, the COMOESTAS Consortium (2009) A narrative review on the management of medication overuse headache: the steep road from experience to evidence. J Headache Pain 10:407–417

    Article  PubMed  Google Scholar 

  • Rossi P, Faroni JV, Nappi G (2010) Short-term effectiveness of simple advice as a withdrawal strategy in simple and complicated medication overuse headache. Eur J Neurol. doi:10.1111/j.1468- 1331.2010.03157

    Google Scholar 

  • Ruiz L, Ferrandi D (2009) Topiramate in migraine progression. J Headache Pain 10:419–422

    Article  PubMed  CAS  Google Scholar 

  • Scher AI, Midgette LA, Lipton RB (2008) Risk factors for headache chronification. Headache 48:16–25

    Article  PubMed  Google Scholar 

  • Shuhendler AJ, Lee S, Siu M, Ondovcik S, Lam K, Alabdullatif A, Zhang X, Machado M, Einarson TR (2009) Efficacy of botulinum toxin type A for the prophylaxis of episodic migraine headaches: a meta-analysis of randomized, double-blind, placebo-controlled trials. Pharmacotherapy 29(7):784–791

    Article  PubMed  CAS  Google Scholar 

  • Silberstein SD, Neto W, Schmitt J, Jacobs D et al (2004) Topiramate in migraine prevention: results of a large controlled trial. Arch Neurol 61:490–495

    Article  PubMed  Google Scholar 

  • Silberstein S, Olesen J, Bousser MG et al (2005) The international classification of headache disorders, 2nd edn (ICHD-II). Revised of criteria for 8.2 medication-overuse headache. Cephalalgia 25:460–465

    Article  PubMed  CAS  Google Scholar 

  • Silberstein SD, Lipton RB, Dodick DW et al (2007) Efficacy and safety of topiramate for the treatment of chronic migraine: a randomized, double-blind, placebo-controlled trial. Headache 47:170–180

    Article  PubMed  Google Scholar 

  • Simmaco M, Borro M, Missori S, Martelletti P (2009) Pharmacogenomics in migraine: catching biomarkers for a predictable disease control. Expert Rev Neurother 9:1267–1269

    Article  PubMed  Google Scholar 

  • Simpson LL (1980) Kinetic studies on the interaction between botulinum toxin type A and the cholinergic neuromuscular junction. J Pharmacol Exp Ther 213:504–508

    PubMed  CAS  Google Scholar 

  • Smith TR, Stoneman J (2004) Medication overuse headache from antimigraine therapy: clinical features, pathogenesis and management. Drugs 64(22):2503–2514

    Article  PubMed  CAS  Google Scholar 

  • Smith TR, Nicholson RA, Banks JW (2010) Migraine education improves quality of life in a primary care setting. Headache 50(4):600–612

    Article  PubMed  Google Scholar 

  • Storer RJ, Goadsby PJ (2004) Topiramate inhibits trigeminovascular neurons in the cat. Cephalalgia 24:1049–1056

    Article  PubMed  CAS  Google Scholar 

  • Stovner LJ, Andree C (2010) Prevalence of headache in Europe: a review of the Eurolight project. J Headache Pain 11(4):289–299

    Article  PubMed  Google Scholar 

  • Stovner LJ, Zwart JA, Hagen K, Terwindt GM, Pascual J (2006) Epidemiology of headache in Europe. Eur J Neurol 13:333–345

    Article  PubMed  CAS  Google Scholar 

  • Stovner LJ, Tronvik E, Hagen K (2009) New drugs for migraine. J Headache Pain 10:395–406

    Article  PubMed  CAS  Google Scholar 

  • Trucco M, Meineri P, Ruiz L, Gionco M, Gruppo Neurologico Ospedaliero Interregionale per lo Studio delle Cefalee” (Neurological Hospital Interregional Group for the Study of Headaches) (2010) Medication overuse headache: withdrawal and prophylactic therapeutic regimen. Headache 50(6):989–997

    Article  PubMed  Google Scholar 

  • Valguarnera F, Tanganelli P (2010) The efficacy of withdrawal therapy in subjects with chronic daily headache and medication overuse following prophylaxis with topiramate and amitriptyline. Neurol Sci 31(Suppl 1):S175–S177

    Article  PubMed  Google Scholar 

  • Vargas BB, Dodick DW (2009) The face of chronic migraine: epidemiology, demographics and treatment strategies. Neurol Clin 27:467–479

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medical and Molecular Sciences, School of Health Sciences, Sapienza University of Rome, Via di Grottarossa 1035, 00189, Rome, Italy

    Paolo Martelletti & Andrea Negro

Authors
  1. Paolo Martelletti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea Negro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paolo Martelletti .

Editor information

Editors and Affiliations

  1. Department of Medical and Molecular Sciences, School of Health Sciences, Sapienza University of Rome, Rome, Italy

    Paolo Martelletti

  2. Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway

    Timothy J. Steiner

  3. Department of Neuroscience, Faculty of Medicine, Imperial College London, London, UK

    Timothy J. Steiner

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Lifting The Burden

About this entry

Cite this entry

Martelletti, P., Negro, A. (2011). Medical Interventions for Migraine That Has Become Difficult to Treat. In: Martelletti, P., Steiner, T.J. (eds) Handbook of Headache. Springer, Milano. https://doi.org/10.1007/978-88-470-1700-9_32

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-1700-9_32

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1699-6

  • Online ISBN: 978-88-470-1700-9

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation