Are There Predictive Factors for Long-Term Outcome after Withdrawal in Drug-Induced Chronic Daily Headache?

• Published in: Cephalalgia Vol. 21; no. 6; pp. 691 - 696
• Main Authors: Tribl, GG, Schnider, P, Wöber, C, Aull, S, Auterith, A, Zeiler, K, Wessely, P
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.07.2001; Blackwell Science Ltd
• Subjects: Adult; Aged; Aged, 80 and over; Analgesics; chronic daily headache; drug withdrawal; ergotamine; Female; Follow-Up Studies; Headache Disorders - physiopathology; Headache Disorders - therapy; Humans; Male; Middle Aged; migraine; Outcome Assessment (Health Care) - statistics & numerical data; predictors for long‐term outcome; Prognosis; Proportional Hazards Models; Recurrence; tension‐type headache; predictors for long-term outcome; migraine; Analgesics; chronic daily headache; ergotamine; drug withdrawal; tension-type headache
• ISSN: 0333-1024; 1468-2982
• DOI: 10.1046/j.1468-2982.2001.00231.x

Objectives To investigate prognostic factors for long-term outcome of patients after inpatient withdrawal because of drug-induced chronic daily headache. Procedures Fifty-five patients (36 females) were re-examined by means of a standardized interview after inpatient withdrawal. The mean observation period was 9.28 ± 2.85 years (mean ± sd; median 8.58; range 5.00–13.50). Results Five years after withdrawal, one-third of the patients (34.6%) had an overall favourable outcome, one-third (32.7%) had no recurrent drug overuse and reported a clear-cut improvement of headache, and one-third (32.7%) developed recurrent drug overuse. Most relapses occurred within 2 years, and a small percentage within 5 years. No predictors for long-term outcome after inpatient withdrawal were found. Conclusions All patients with drug-induced chronic daily headache should be considered as good candidates for inpatient withdrawal, and no patient should be excluded from that therapy.