Favorable response to analgesics does not predict a benign etiology of headache.
Headache
; 48(6): 944-50, 2008 Jun.
Article
in En
| MEDLINE
| ID: mdl-18479425
ABSTRACT
BACKGROUND:
Distinguishing between primary and secondary headaches (HAs) is essential for the safe and effective management of patients with HA. A favorable response to analgesics may be observed with both classes of HAs and therefore is not a good predictor of who needs further evaluation.OBJECTIVE:
To systematically review the data that a favorable response to analgesics including triptans should not be used to exclude a serious secondary cause of HA.DESIGN:
PubMed search of English-language articles between 1980 and 2007 and reference lists of these articles. Two authors independently reviewed articles for study results and quality. Inclusion was based on 100% agreement between authors. We included articles that described secondary HAs as (1) having a favorable response to analgesics and/or (2) having a favorable response to sumatriptan. Of the 548 studies identified by our search strategy, 18 were included in our final analysis.RESULTS:
Seven of the 18 studies found that 46/103 patients (44%) described a significant or complete resolution of secondary HA from medications such as anti-emetics and nonsteroidal anti-inflammatory drugs (NSAIDs). Eleven of the 18 articles including 25/25 patients (100%) described a significant or complete resolution of secondary HA from sumatriptan, a serotonin 5HT agonist.CONCLUSIONS:
A favorable response to analgesics including triptans should not be used to exclude a serious secondary cause of HA.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Headache
/
Analgesics
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
Headache
Year:
2008
Document type:
Article
Affiliation country: