Sørnes EØ, Risal A, Manandhar K, Thomas H, Steiner TJ, Linde M. Use of medicinal plants for headache, and their potential implication in medication-overuse headache: Evidence from a population-based study in Nepal.
Cephalalgia 2021;
41:561-581. [PMID:
33435708 PMCID:
PMC8047708 DOI:
10.1177/0333102420970904]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background
In Nepal, traditional treatment using medicinal plants is popular. Whereas
medication-overuse headache is, by definition, caused by excessive use of
acute headache medication, we hypothesized that medicinal plants, being
pharmacologically active, were as likely a cause.
Methods
We used data from a cross-sectional, nationwide population-based study, which
enquired into headache and use of medicinal plants and allopathic
medications. We searched the literature for pharmacodynamic actions of the
medicinal plants.
Results
Of 2100 participants, 1794 (85.4%) reported headache in the preceding year;
161 (7.7%) reported headache on ≥15 days/month, of whom 28 (17.4%) had used
medicinal plants and 117 (72.7%) allopathic medication(s). Of 46 with
probable medication-overuse headache, 87.0% (40/46) were using allopathic
medication(s) and 13.0% (6/46) medicinal plants, a ratio of 6.7:1, higher
than the overall ratio among those with headache of 4.9:1 (912/185). Of 60
plant species identified, 49 were pharmacodynamically active on the central
nervous system, with various effects of likely relevance in
medication-overuse headache causation.
Conclusions
MPs are potentially a cause of medication-overuse headache, and not to be
seen as innocent in this regard. Numbers presumptively affected in Nepal are
low but not negligible. This pioneering project provides a starting point
for further research to provide needed guidance on use of medicinal plants
for headache.
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