@article{86a85e18f7c6472eb21e8a5c7e6f43c8,
title = "Dependent behavior in patients with medication-overuse headache",
abstract = "Two thirds of patients with medication-overuse headache (MOH) fulfilled criteria for dependence on acute symptomatic treatments for pain, not exclusive of psychoactive medications, based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. Several questionnaires have been used to assess dependent behavior in patients with MOH. Findings regarding underlying psychological profiles of dependence and MOH are not consistent. Nevertheless, several neuroimaging, genetic, and neurobiological studies support the existence of the common pathophysiological features of dependence and MOH and suggest a link between them. This review highlights recent studies on the relationship between dependence and MOH. This issue is important because it implies a treatment strategy in managing patients with MOH by providing the treatment of dependence.",
keywords = "Affective disorders, Analgesics, Chronic daily headache, Comorbidity, Medication-overuse headache, Migraine, Psychological factors, Substance dependence",
author = "Fuh, {Jong Ling} and Wang, {Shuu Jiun}",
note = "Funding Information: Acknowledgement This study was supported by grants from the Veterans{\textquoteright} General Hospital University System of Taiwan (VGHUST) Joint Research Program (VGHUST100-G7-1-3 & VGHUST100-G7-1-1). Funding Information: A clinical endocannabinoid deficiency was proposed to play a role in the pathophysiology of migraine, fibromyal-gia, and irritable bowel syndrome [40]. In support of this hypothesis, Sarchielli and colleagues [41] found cerebro-spinal fluid (CSF) concentrations of anandamide (AEA), a biologically active endocannabinoid, were lower in patients with chronic migraine with or without MOH than in nonmigraine control patients [41]. They further demonstrated the platelet levels of AEA and 2-acylglycerol, another biologically active endocannabinoid, were lower in patients with chronic migraine with and without MOH than in control patients, and serotonin levels also were reduced in these two CDH patient groups, with higher values for the MOH patients [42]. The authors proposed that an imbalance of the endocannabinoid and serotonergic systems may contribute to the pathogenesis of chronic migraine and MOH [42]. The hypothesis was supported by the mechanism of acetaminophen, which is a very commonly overused medication in MOH. A recent study showed acetaminophen may reinforce the activity of the endocannabinoid system, then reinforce the activity of the bulbospinal serotonergic inhibitory pathways, and finally block the transmission of nociceptive influx [43 ]. Acetaminophen may contribute to the imbalance in the endocannabinoid and serotonergic systems. These data are just preliminary and require further studies for verification.",
year = "2012",
month = feb,
doi = "10.1007/s11916-011-0240-0",
language = "English",
volume = "16",
pages = "73--79",
journal = "Current Pain and Headache Reports",
issn = "1531-3433",
publisher = "Current Science, Inc.",
number = "1",
}