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Peck J, Urits I, Zeien J, Hoebee S, Mousa M, Alattar H, Kaye AD, Viswanath O. A Comprehensive Review of Over-the-counter Treatment for Chronic Migraine Headaches. Curr Pain Headache Rep 2020; 24:19. [PMID: 32200435 DOI: 10.1007/s11916-020-00852-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE OF REVIEW Migraine headaches are a neurologic disorder characterized by attacks of moderate to severe throbbing headache that are typically unilateral, exacerbated by physical activity, and associated with phonophobia, photophobia, nausea, and vomiting. In the USA, the overall age-adjusted prevalence of migraine in female and male adults is 22.3% and 10.8%, respectively. RECENT FINDINGS Migraine is a disabling disease that ranks as the 8th most burdensome disease in the world and the 4th most in women. The overarching hypothesis of migraine pathophysiology describes migraine as a disorder of the pain modulating system, caused by disruptions of the normal neural networks of the head. The activation of these vascular networks results in meningeal vasodilation and inflammation, which is perceived as head pain. The primary goals of acute migraine therapy are to reduce attack duration and severity. Current evidence-based therapies for acute migraine attacks include acetaminophen, four nonsteroidal anti-inflammatory drugs (NSAIDs), seven triptans, NSAID-triptan combinations, dihydroergotamine, non-opioid combination analgesics, and several anti-emetics. Over-the-counter medications are an important component of migraine therapy and are considered a first-line therapy for most migraineurs. These medications, such as acetaminophen, ibuprofen, naproxen, and aspirin, have shown strong efficacy when used as first-line treatments for mild-to-moderate migraine attacks. The lower cost of over-the-counter medications compared with prescription medications also makes them a preferred therapy for some patients. In addition to their efficacy and lower cost, over-the-counter medications generally have fewer and less severe adverse effects, have more favorable routes of administration (oral vs. subcutaneous injection), and reduced abuse potential. The purpose of this review is to provide a comprehensive evidence-based update of over-the-counter pharmacologic options for chronic migraines.
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Affiliation(s)
- Jacquelin Peck
- Department of Anesthesiology, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL, 33140, USA.
| | - Ivan Urits
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Justin Zeien
- University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Shelby Hoebee
- University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Mohammad Mousa
- University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Hamed Alattar
- University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Alan D Kaye
- Department of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University School of Medicine, Shreveport, LA, USA
| | - Omar Viswanath
- Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
- Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA
- Valley Anesthesiology and Pain Consultants, Envision Physician Services, Phoenix, AZ, USA
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Radman M, Babic A, Runjic E, Jelicic Kadic A, Jeric M, Moja L, Puljak L. Revisiting established medicines: An overview of systematic reviews about ibuprofen and paracetamol for treating pain in children. Eur J Pain 2019; 23:1071-1082. [DOI: 10.1002/ejp.1380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 02/01/2019] [Accepted: 02/17/2019] [Indexed: 12/15/2022]
Affiliation(s)
| | - Andrija Babic
- Institute of Emergency Medicine in Split‐Dalmatia County Split Croatia
| | - Edita Runjic
- Department of Pediatrics University Hospital Split Split Croatia
| | | | - Milka Jeric
- Department of Dermatovenerology General Hospital Zadar Zadar Croatia
| | - Lorenzo Moja
- Unit of Clinical Epidemiology IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Biomedical Sciences for Public Health Università degli Studi di Milano Milan Italy
| | - Livia Puljak
- Center for Evidence‐Based Medicine and Health Care Catholic University of Croatia Zagreb Croatia
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