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¿El abuso de fármacos en pacientes con migraña crónica influye en la efectividad del tratamiento preventivo con topiramato? / Does medication abuse in patients with chronic migraine influence the effectiveness of preventive treatment with topiramate?
Gracia Naya, Manuel; Hernando Quintana, Natalia; Latorre Jimenez, Ana M; Rios, Consuelo; Artal Roy, Jorge; Garcia Gomara, M Jose; Santos Lasaosa, Sonia; Sanchez Valiente, Sara; Mauri Llerda, Jose Angel.
Affiliation
  • Gracia Naya, Manuel; Hospital Universitario Miguel Servet. Zaragoza. España
  • Hernando Quintana, Natalia; Hospital Universitario Miguel Servet. Zaragoza. España
  • Latorre Jimenez, Ana M; Hospital San Jorge. Huesca. España
  • Rios, Consuelo; Hospital Royo Villanova. Zaragoza. España
  • Artal Roy, Jorge; Hospital Universitario Miguel Servet. Zaragoza. España
  • Garcia Gomara, M Jose; Hospital Universitario Miguel Servet. Zaragoza. España
  • Santos Lasaosa, Sonia; Hospital Clínico Universitario. Zaragoza. España
  • Sanchez Valiente, Sara; Hospital Clínico Universitario. Zaragoza. España
  • Mauri Llerda, Jose Angel; Hospital Clínico Universitario. Zaragoza. España
Rev. neurol. (Ed. impr.) ; 59(9): 385-391, 1 nov., 2014. tab, graf
Article in Spanish | IBECS | ID: ibc-128863
Responsible library: ES1.1
Localization: BNCS
RESUMEN
Introducción. Los pacientes con migraña crónica (MC) y abuso de medicación son difíciles de tratar y tienen peor calidad de vida que otros pacientes con migrañas. Objetivo. Valorar si la presencia de abuso de fármacos disminuye la efectividad del topiramato. Pacientes y métodos. Una serie de pacientes con MC fueron agrupados según presentasen criterios de abuso o no abuso de fármacos. Se les aconsejo la supresión del fármaco del cual abusaban. Se ajustó el tratamiento de sus crisis y se inició tratamiento preventivo desde el principio con topiramato. Se valoró el número días con cefalea y migrañas intensas en el mes previo y al cuarto mes de tratamiento. Resultados. Fueron seleccionados 262 pacientes con criterios de MC, y de ellos 167 (63,7%) cumplieron criterios de abuso. En ambos grupos hubo una reducción significativa del número de días con cefalea/mes y numero de crisis de migraña/mes al cuarto mes de tratamiento con topiramato. Porcentaje de reducción de días con cefalea/mes en MC sin abuso, 59,3} 36,1%; y con abuso, 48,7} 41,7% (p = 0,0574). Porcentaje de reducción de migrañas intensas/mes en MC sin abuso, 61,2%; y con abuso, 50% (p = 0,0224). Tasa de respondedores según numero de días con cefalea/mes en MC sin abuso, 69%; y con abuso, 57%. Tasa de respondedores según numero de migrañas intensas/mes en MC sin abuso, 76,8%; y en MC con abuso, 61% (p = 0,0097). Conclusiones. El topiramato fue efectivo en pacientes con MC sin y con abuso de fármacos, aunque con menor efectividad en estos últimos (AU)
ABSTRACT

Introduction:

Patients with chronic migraine (CM) and medication abuse are difficult to treat, and have a greater tendency towards chronification and a poorer quality of life than those with other types of headache.

Aim:

To evaluate whether the presence of medication abuse lowers the effectiveness of topiramate. Patients and

methods:

A series of patients with CM were grouped according to whether they met abuse criteria or not. They were advised to stop taking the drug that they were abusing. Treatment was adjusted to match their crises and preventive treatment with topiramate was established from the beginning. The number of days with headache and intense migraine in the previous month and at four months of treatment was evaluated. Results. In all, 262 patients with CM criteria were selected and 167 (63.7%) of them fulfilled abuse criteria. In both groups there was a significant reduction in the number of days with headache/month and number of migraine attacks/month at the fourth month of treatment with topiramate. The percentage of reduction in the number of days with headache/ month in CM without abuse was 59.3} 36.1%, and with abuse, 48.7} 41.7% (p = 0.0574). The percentage of reduction in the number of days with intense migraine/month in CM without abuse was 61.2%, and with abuse, 50% (p = 0.0224). Response rate according to the number of days with headache/month in CM without abuse was 69%, and with abuse, 57%. Response rate according to the number of intense migraines/month in CM without abuse was 76.8%, and in CM with abuse, 61% (p = 0.0097). Conclusions. Topiramate was effective in patients with CM with and without medication abuse, although effectiveness is lower in the latter case (AU)
Subject(s)
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Collection: National databases / Spain Health context: Sustainable Health Agenda for the Americas / SDG3 - Health and Well-Being Health problem: Goal 9: Noncommunicable diseases and mental health / Target 3.4: Reduce premature mortality due to noncommunicable diseases / Target 3.5: Prevention and treatment of consumption of psychoactive substances Database: IBECS Main subject: Substance-Related Disorders / Migraine Disorders / Anticonvulsants Type of study: Etiology study / Risk factors Aspects: Patient-preference Limits: Humans Language: Spanish Journal: Rev. neurol. (Ed. impr.) Year: 2014 Document type: Article Institution/Affiliation country: Hospital Clínico Universitario/España / Hospital Royo Villanova/España / Hospital San Jorge/España / Hospital Universitario Miguel Servet/España
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Collection: National databases / Spain Health context: Sustainable Health Agenda for the Americas / SDG3 - Health and Well-Being Health problem: Goal 9: Noncommunicable diseases and mental health / Target 3.4: Reduce premature mortality due to noncommunicable diseases / Target 3.5: Prevention and treatment of consumption of psychoactive substances Database: IBECS Main subject: Substance-Related Disorders / Migraine Disorders / Anticonvulsants Type of study: Etiology study / Risk factors Aspects: Patient-preference Limits: Humans Language: Spanish Journal: Rev. neurol. (Ed. impr.) Year: 2014 Document type: Article Institution/Affiliation country: Hospital Clínico Universitario/España / Hospital Royo Villanova/España / Hospital San Jorge/España / Hospital Universitario Miguel Servet/España
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