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Medication overuse headache is the chronicity of headaches, which occurs more than 15 days a month, as a result of frequent use of painkillers, opioids or migraine attack drugs (ergotamine, triptan) in individuals with pre-existing primary headache disease.
In the treatment of this headache, two ways can be followed as slow drug discontinuation or sudden drug discontinuation. The most commonly used method is the sudden discontinuation of the overused analgesic agent, the initiation of prophylactic treatment, and then the application of bridge therapy for 6-10 days. Intravenous hydration, steroids, antiemetics, neuroleptic drugs and local anesthetic drugs such as lidocaine can be used in bridge treatment.
In our clinic, we routinely apply intravenous 1.5 mg/kg lidocaine, intravenous prednisolone and intravenous saline treatments as bridge treatment to patients diagnosed with medication overuse headache. In this study, we aimed to compare the efficacy of intravenous lidocaine, intravenous steroids and intravenous hydration therapy, which were used as bridge therapy after the cessation of analgesic use in patients with medication overuse headache.
Patients who applied to the algology outpatient clinic and who were diagnosed with drug overuse headache and treated were evaluated by dividing them into 3 different groups. It was planned to include 15 patients in each group. The first group consists of patients who were given 500 cc of intravenous saline for 1 hour in the service. The second group consisted of patients who were given 80 mg intravenous prednisolone for the first 4 days and then gradually reduced doses of prednisolone in the following days. The third group includes patients in whom 2 mg/kg intravenous lidocaine was administered as a 1-hour infusion, monitored in the ward.
Pain intensity will be evaluated by visual analog scale (VAS) in all patients after treatment, at 1 month and 3 months. In addition, the number of days with pain and the number of analgesics used in the 3-month period after the end of the treatment will be evaluated and the Quality of Life Scale will be applied.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group given intravenous hydration | Active Comparator | The first group consists of patients given 500 cc intravenous saline for 1 hour. |
|
| Group given intravenous prednisolone | Active Comparator | Second group; consists of patients who were given 80 mg of intravenous prednisolone for the first 4 days and then given gradually decreasing doses of prednisolone in the following days. |
|
| Group given intravenous lidocaine | Active Comparator | Third group; includes patients given 2 mg/kg intravenous lidocaine by 1-hour infusion. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intravenous hydration | Other | 500 cc intravenous serum for 1 hour in the first group service consists of patients who have been given. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Visual analog scale (VAS) | It is a scale that measures the severity of pain. Scored between ''0: no pain'' and ''10: worst pain'' . | 4 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ömer Taylan Akkaya | Diskapi Yildirim Beyazıt Teaching and Research Hospital | Study Chair |
| Gevher Rabia Genç Perdecioğlu | Diskapi Yildirim Beyazıt Teaching and Research Hospital | Study Director |
| Hüseyin Alp Alptekin | Diskapi Yildirim Beyazıt Teaching and Research Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Diskapi Yildirim Beyazıt Teaching and Research Hospital | Ankara | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D051271 | Headache Disorders, Secondary |
| ID | Term |
|---|---|
| D020773 | Headache Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Intravenous prednisolone | Other | The second group consisted of patients who were given 80 mg intravenous prednisolone for the first 4 days and then gradually reduced doses of prednisolone in the following days. |
|
| Intravenous lidocaine | Other | The third group includes patients in whom 2 mg/kg of intravenous lidocaine is given by 1-hour infusion. |
|