Neurologia i neurochirurgia polska

[Drug rebound headaches].

PMID 11107562


The term "drug rebound headache" refers to headaches occurring every day in patients with migraine and tension headaches as a consequence of taking analgesics or ergotamine every day. Their cause is a vicious circle mechanism. This form of headache has been discovered in recent years and it is supposed that about 20% of patients with chronic headaches belong to that category. The only way to disrupt this vicious circle is immediate complete abandoning of these drugs. The abstinence period with associated troublesome symptoms lasts several to up to 20 days. Antidepressants are given for their alleviation. The author prescribes opipramol /Pramolan/ which is taken by increments from half tablet up to three in 6 days and the treatment is then continued for 4-6 weeks. From the 6th day on the patient should completely discontinue taking of analgesics. The material observed by the author comprises 47 patients /45 women/ aged 19-57 years, mean age 41 years, with these headaches continuing since 1-12 years /mean 3.0 years/. The above described method gave good results in 32 cases. In 10 cases complete withdrawal of analgesics was not possible by this method was abandoned accepting that their headaches were not due to drug abuse.

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Opipramol dihydrochloride, ≥98% (HPLC), solid
C23H29N3O · 2HCl