Day-hospital withdrawal for chronic migraine with medication overuse: results at 3 years follow-up.

摘要

Patients with chronic headache and medication overuse are particularly difficult to treat, with no one approach being universally accepted. Some type ofwithdrawal program, however, is typically implemented before beginning apharmacological prophylaxis treatment. Different withdrawal modalities have been performed for managing these patients: at first step, in-patient withdrawal hasbeen confirmed effective in preceding clinical experiences. In recent years, new modalities for withdrawal have been developed as day-hospital setting. Purpose ofthis study was to determine the clinical course of a sample of chronic migrainepatients with medication overuse 3 years after day-hospital withdrawal. A groupof 202 patients were treated. Patients were suffering from chronic migraine with medication overuse according with IHS criteria. All patients were submitted to a day-hospital withdrawal and then they were followed with meetings every 3 months until the first year and then every 6 months until the last follow-up 3 yearsafter withdrawal. Eighty patients achieved the last follow-up meeting 3 yearsafter withdrawal. Patients clinically improved, significantly, both for days ofheadache per month and consumption of medications per month. From these results, the day-hospital setting for withdrawal, followed by periodic clinical meetings, seems to be effective for this category of patients to improve significantly atlong-term headache frequency and analgesics intake.