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The majority of patients overused more than one type of medication. Transformed migraine and medication overuse in a tertiary headache centre--clinical characteristics and treatment outcomes.Studies suggest that a substantial proportion of headache sufferers presenting to headache clinics may overuse acute medications. Opiate use > 1 tablet a day for > ultram overdose symptoms
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2 days a week; 4. Beta-blockers and psychic stress. We compared the following outcomes after one year of follow-up. More rigorous prescribing guidelines for patients with frequent headaches are urgently needed. Patients who were not able to discontinue offending agents, or returned to a pattern of medication overuse within one year were considered to have unsuccessful detoxification (Group 2). At the same times patients were requested to play a game of manual skill called quot;Go Downquot;. Forty-eight (10.5%) subjects took >10 tablets per day. Simple analgesic use (>1000 mg ASA/acetaminophen) > 5 days/week; 2. For triptans, we empirically considered overuse > 1 tablet per day for >
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5 days per week. The comparison between groups 1 and 2 after one year of follow-up sho a decrease in the frequency
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of headache of 73.7% in group 1 and only barrier contraceptives 17.2% in group 2 (P < 0.0001). Of 456 patients, 318 (69.7%) were successfully detoxified (Group 1), and 138 (30.3%) were not (Group 2). The headache score after one year
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was 18.8 in group 1 and 54 in group 2 (P < 0.0001). Positive effects were obtained in patients treated with BP, at both doses, on ease of quot;falling asleepquot;, number of quot;night awakeningsquot;
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and quot;reawakening moodquot; while LR and BT were mostly ineffective, except for BT on ease of quot;falling asleepquot;. Number of days with headache per month; Intensity of headache; Duration of headache; headache score (frequency x intensity). Patients who were able to undergo detoxification and did not overuse medication (based on the above definition) after one year of follow-up were considered to have successful detoxification (Group 1). The next
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day, in the morning (time 2), the patients were given the same questionnaire and were asked a series of questions about their sleep and awakening. Basal) and in the evening (time 1). Successful detoxification is necessary to ensure improvement in the headache status when treating patients who overuse acute medications.
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In some cases, overuse may
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be responsible for the development or maintenance of a chronic daily headache (CDH) syndrome. It was concluded that a beta-blocker such as bopindolol may be more effective than a benzodiazepine or a barbiturate for the prevention of anxiety symptoms induced by a clearly defined stress situation, such as awaiting a surgical operation. Considering patients seen in the last 5 years, we found the following overused substances. Similarly, the duration of head pain was reduced by 61.2% in group 1 and 14.8% in group 2 (P < 0.0001). A double-blind, placebo-controlled study of bopindolol vs lorazepam and Butalbital ( Fioricet
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) in surgical patients.One hundred patients scheduled for surgery participated in a randomized double-blind trial designed to evaluate the effects of acute treatment with two doses of bopindolol (1 mg:BP1;2 mg:BP2) in comparison with those of 2.5 mg lorazepam (LR), 75 mg Butalbital ( Fioricet ) (BT) and placebo (PL). 1 mg PO or 0.5 mg PR for > 2 days a week. Combination analgesics use (caffeine and/or Butalbital ( Fioricet )) > 3 tablets a day for > 3 days a week; 3. Mean anxiety scores were significantly increased over basal values at both time 1 and time 2 in the PL and LR groups and at
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time 2 in the BT group, but neither in the BP1 nor in the BP2 group. A total of 225 (70.7%) successfully detoxified subjects in Group 1 returned to an episodic pattern of migraine, compared to 21 (15.3%) in Group 2 (P < 0.001). The time needed to perform the quot;Go Downquot; test was significantly shorter than the basal value for both BP groups and significantly longer for the BT group, while nonsignificant modifications occurred in the PL and LR groups. Butalbital ( Fioricet ) containing combination products,
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48%; Acetaminophen, 46.2%; Opioids, 33.3%; ASA, 32.0%; Ergotamine tartrate, 11.8%; Sumatriptan, 10.7%; Nonsteroidal anti-inflammatory medications other than ASA, 9.8%; Zolmitriptan, 4.6%; Rizatriptan, 1.9%; Naratriptan, 0.6%. The objectives of this study are to evaluate patterns of analgesic overuse in patients consulting a headache centre and to compare the outcomes in a group of patients who discontinued medication overuse to those of a group who continued the overuse, in patients with similar age, sex and psychological profile. Anxiety was evaluated by the STAI X1 questionnaire on the day before surgery, in the late afternoon (time 0.
We revie charts of 456 patients with transformed migraine (TM) and acute medication overuse defined by one of the following criteria. Numbers of tablets taken ranged from 1 to 30 each day (mean of 5.2).
