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Erschienen in: DGNeurologie 4/2022

19.05.2022 | Arzneimittelinduzierter Kopfschmerz | Leitlinie

S1-Leitlinie: Kopfschmerz bei Übergebrauch von Schmerz- oder Migränemitteln

Leitlinie der Deutschen Gesellschaft für Neurologie

verfasst von: Prof. Dr. H.-C. Diener, P. Kropp

Erschienen in: DGNeurologie | Ausgabe 4/2022

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Auszug

  • Die Klassifikation der Kopfschmerzen durch die International Headache Society (IHS) spezifiziert die Medikamente, die einen Kopfschmerz durch Übergebrauch von Schmerz- oder Migränemitteln („medication overuse headache“, MOH) hervorrufen können.
  • Die weltweite Prävalenz des MOH liegt zwischen 0,7 % und 1 %. Die gesellschaftlichen Kosten bei der Behandlung des MOH liegen 3‑mal höher als die bei der Behandlung der episodischen Migräne.
  • Die wichtigsten Risikofaktoren für einen MOH sind: vorbestehende primäre Kopfschmerzen, z. B. Migräne oder Kopfschmerz vom Spannungstyp, weibliches Geschlecht, > 10 Kopfschmerztage pro Monat, niedriger sozialer Status, andere chronische Schmerzerkrankungen, Stress, körperliche Inaktivität, Übergewicht, Rauchen, abhängiges Verhalten und andere psychiatrische Erkrankungen wie Depression oder Angsterkrankung.
  • Die monoklonalen Antikörper gegen CGRP („Calcitonin Gene Related Peptide“) oder den CGRP-Rezeptor sind wie Topiramat und Onabotulinumtoxin A in der Prophylaxe der chronischen Migräne wirksam. Dies gilt auch für Patienten mit Kopfschmerzen durch Übergebrauch von Schmerz- oder Migränemitteln.
  • Nichtmedikamentöse Maßnahmen ergänzen die medikamentöse Prophylaxe bei MOH.
  • Die größte Gefahr eines Rückfalls besteht im ersten Jahr nach einer Medikamentenpause oder einem Medikamentenentzug.
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Metadaten
Titel
S1-Leitlinie: Kopfschmerz bei Übergebrauch von Schmerz- oder Migränemitteln
Leitlinie der Deutschen Gesellschaft für Neurologie
verfasst von
Prof. Dr. H.-C. Diener
P. Kropp
Publikationsdatum
19.05.2022
Verlag
Springer Medizin
Erschienen in
DGNeurologie / Ausgabe 4/2022
Print ISSN: 2524-3446
Elektronische ISSN: 2524-3454
DOI
https://doi.org/10.1007/s42451-022-00443-w

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ANZEIGE

Schmerztherapie erleichtern - Auf 1x im Leben

Wie Sie bei starken chronischen Schmerzen die Therapie Ihrer Patienten mit Hilfe von ultraretardierten oralen Opioiden praxisrelevant optimieren und die Compliance sowie Lebensqualität Ihrer Patienten effektiv verbessern können, das erfahren Sie anschaulich in den folgenden Beiträgen.