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Message: Urgent need for research into the best ringing in the ears medication overuse headaches
There is a critical need to review current treatment strategies of the increasingly common problem of medication overuse headaches (MOH), According to a series of worldwide papers in the November issue of Cephalalgia. “MOH is associated with severe disability, Unmet treatment need and little clinical data compliment current management strategies” Says neurology expert Professor David W Dodick from the Mayo Clinic College of medicine, scottsdale, american.
His overview also highlights the need for greater research into the condition in particular the role that migraine medication can play in the withdrawal process. It is and papers on how the condition is tackled in Canada, Denmark, indonesia, of india, Moldova, okazaki, japan, southern spain and Taiwan.
MOH, years ago known as rebound headache, Drug induced major problem or drug misuse hassle, Is a headache that is caused at least 15 days a month when patients overuse medication.
“ability to tolerate the analgesic effect of the acute medication develops over time, eating may increase and patients may show withdrawal symptoms when they stop the overused mediation” Explains professor Dodick. “We estimate that that tinnitus affects one in every 100 adults and one in every 200 adolescents worldwide, Which is a large number.
“for example, In the USA 60 per cent of people with chronic daily moldova women headaches attending headache clinics have MOH. Data from a physician study suggests that it may be the third most frequent type of headache after migraines and tension type headaches. And a Norwegian study found that people were seven times more likely to suffer from chronic headaches if they used analgesics daily or almost daily for more than a month,
Despite being usual, there aren’t any standardised treatment guidelines for MOH, Partly due to the small number of controlled clinical trials that have addressed the treating this condition.
even so, Recent studies suggest that the traditional approach of not providing new treatment strategies until patients have been through detoxification may not be the best clinical option.
“Data from recent trials indicate that treatments developed to prevent migraine may prove effective if they are utilized in patients with MOH before the overused medicine is withdrawn” Says tutor Dodick.
“This points to the need for clinical trials to re evaluate current strategies and find a very good way forward,
The international papers that is included with Dr Dodick’s overview show that MOH is a common problem, But the chance, Causes and treatment vary from state to state.
Just under a quarter of the MOH cases seen at Taipei Veterans General Hospital in Taiwan originate people overusing cold cure preparations. Dr Shuu Jiun Wang points out that 100 brands are that you can buy in Taiwan and he and his colleagues frequently see patients who have taken the whole 60ml bottle rather than the 10ml recommended dose. the thing is more common in people with lower education levels. Other common the things that cause MOH, Which affect one in 100 Taiwanese those, Include pain killers, With or without caffeine containing drinks.
Dr Zaza Katsarava from the University of Essen in Germany reports that new rules that enable healthcare plans to sign contracts with headache centres to provide day care centre withdrawal programmes have reduced MOH relapse rates in the wilderness. He says that studies lasting from three to five years have indicated that relapse rates range from 34 to 48 per cent.
Medication moldova women overuse is a major clinical problem and a good source of headache related disability in Canada, according to Professor Werner J Becker from the University of Calgary. He believes that it’ll take a concerted effort by the public, health care professionals and healthcare funders to provide better prevention and treatment for MOH. But he points out: “It can at times be a hardship on patients to find a physician who will expend the time, Energy and skill to help them escape from the prison of medication overuse,
MOH is a serious issue in Spain, Especially among older women, Says Professor Julio Pascual from the university Hospital at Salamanca. He advocates an active detection and intervention approach, Pointing out that in his experience this might lead to long term improvements in more than half of MOH cases. However he adds that patients with primary headache is sometimes biologically, and maybe genetically, Predisposed to developing chronic daily headaches in spite of analgesic use, Making the drugs the punishment, Not the cause of daily headaches.
Dr Rigmor Jensen from the university or of Copenhagen, Denmark, Says that MOH has become a greater problem in Scandinavia over the last decade and is now the third most prevalent form of headache after tension type headaches and migraine. “A traditional tradition of restrictive use of painkillers is changing and in general the use of simple analgesics and combination drugs has steadily increased in Denmark” states.
The drugs that cause MOH may vary from country to country says Dr Rie Kanki from Kitasato University in Kanagawa, okazaki, japan, As their market presence may differ and people’s attitudes can be greatly affected by cultural attitudes. as an example codeine and barbiturates, Which are used mixed with analgesics in the USA and Europe, Are unavailable in Japan. Dr Kanki says that patient education is essential and that the growing number of headache specialists in Japan is making it easier to seek expert advice.
People living in Moldova often face sentimental, Cultural and psychic barriers to drug use, According to Dr Ion Moldovanu from the State Medical and pharmaceutical University in Chisinau. He reports that a clinical study of chronic migraine patients found that the two thirds who did not have MOH expressed truly greater phobias about the effects of drugs. for this reason they used fewer drugs than the third of patients who did have MOH.
Limited clinical data suggests that MOH is not as prevalent in India as it is in Europe and the US, Reports Dr K Ravishankar from the Lilavati Hospital and analyse Centre in Mumbai. He suggests this could be because those tend to use pain balms, Delay medication and use complementary treatment. within the, He says that more population based studies are needed in the usa, Where access to healthcare is difficult and costly and headaches are not a priority in comparison with AIDS, Malaria and as well,as well as the TB.
“It is clear from the papers in this issue of Cephalalgia that MOH is a common universal problem and that many countries face unique challenges due to the drugs which may be used, Patient and physician attitudes and numerous health care delivery systems” expresses Dr Dodick, Who will need over as Editor in Chief of Cephalalgia in January 2009.
“although, The overwhelming consensus is that MOH is a growing problem that has a major negative impact on health related total well being. it’s critical to identify patients with a high frequency of headaches, Who are at dangerous of MOH, as fast as possible and initiate measures to reduce the consumption of acute pain medication.
“This is a series of papers as it illustrates the global public health burden imposed by MOH and identifies the unique underlying factors that contribute to MOH in different countries, in addition country specific barriers to treatment.