Volume 4, Issue 12 (Winter 2018)                   Caspian.J.Neurol.Sci 2018, 4(12): 13-17 | Back to browse issues page


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1- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2- MD Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract:   (589 Views)
Background:Treatment of Medication Overuse Headache (MOH) is yet under debate and Celecoxib as a Cyclooxygenase 2 (COX2) -inhibitor has not been tried widely as a pain relief drug for this type of headaches in migrainous patients. 
Objectives: comparing the efficacy of celecoxib versus prednisolone for withdrawal period of MOH.
Materials & Methods: A double-blind, randomized clinical trial was carried out, on 75 patients with MOH who visited the Isfahan Neurology Clinic in 2016. They were assigned into two groups of oral prednisolone and celecoxib prescribed for 15 days. Any changes in the duration (average hours of daily headache), frequency, and severity of headaches, and intake of rescue medication and their side effects were recorded after the 15-day intervention period. Data were analyzed by independent t, paired t, Mann-Whitney, Wilcoxon test, and chi-square tests in SPSS software version 20.
Results: Average duration of headache in both groups significantly decreased after treatment (P<0.001). It decreased significantly in celecoxib group (P=0.04). Headache frequency decreased more but not significantly in the celecoxib group (P=0.08). Considering MIGSEV (Migraine Severity) and VAS (Visual Analogue Scale) scales, headache severity alleviated significantly after treatment in both groups (P<0.001). The decrease was more noticeable in the celecoxib group. Need for rescue medications (P=0.048), and side effect appearance (P=0.001) was also lower in patients who took celecoxib, compared to the other group.
Conclusion: Celecoxib showed higher efficacy and fewer side effects, compared to prednisolone in treatment of medication overuse headache in migrainous patients.
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Type of Study: Research | Subject: Special
Received: 2017/07/3 | Accepted: 2017/10/5 | Published: 2018/01/1

References
1. Katsarava Z, Diener HC. Medication overuse headache in Germany. Cephalalgia. 2008; 28(11):1221–2. doi: 10.1111/j.1468-2982.2008.01734.x [DOI:10.1111/j.1468-2982.2008.01734.x]
2. Hagen K, Jensen R, Bøe MG, Stovner LJ. Medication overuse headache: A critical review of end points in recent follow-up studies. J Headache Pain. 2010; 11(5):373–7. doi: 10.1007/s10194-010-0221-4 [DOI:10.1007/s10194-010-0221-4]
3. Krymchantowski A, Moreira P. Out-patient detoxification in chronic migraine: Comparison of strategies. Cephalalgia. 2003; 23(10):982–93. doi: 10.1046/j.1468-2982.2003.00648.x [DOI:10.1046/j.1468-2982.2003.00648.x]
4. Negro A, D'Alonzo L, Martelletti P. Chronic migraine: Comorbidities, risk factors, and rehabilitation. Intern Emerg Med. 2010; 5(S1):13–9. doi: 10.1007/s11739-010-0457-7 [DOI:10.1007/s11739-010-0457-7]
5. Silberstein SD. Medication overuse headache. New York: American Headache Society; 2008.
6. Rabe K, Pageler L, Gaul C, Lampl C, Kraya T, Foerderreuther S, et al. Prednisone for the treatment of withdrawal headache in patients with medication overuse headache: A randomized, double-blind, placebo-controlled study. Cephalalgia. 2012; 33(3):202–7. doi: 10.1177/0333102412462638 [DOI:10.1177/0333102412462638]
7. Cevoli S, Giannini G, Favoni V, Terlizzi R, Sancisi E, Nicodemo M, et al. Treatment of withdrawal headache in patients with medication overuse headache: A pilot study. J Headache Pain. 2017; 18(1). doi: 10.1186/s10194-017-0763-9 [DOI:10.1186/s10194-017-0763-9]
8. Boe MG, Mygland A, Salvesen R. Prednisolone does not reduce withdrawal headache: A randomized, double-blind study. Neurology. 2007; 69(1):26–31. doi: 10.1212/01.wnl.0000263652.46222.e8 [DOI:10.1212/01.wnl.0000263652.46222.e8]
9. Toghae M, Ghini MR, Paknejad SM, Taghvaii Zahmat Kesh E, Ramim T. Celecoxib versus prednisolone in medication overuse headache withdrawal treatment: double blind randomized clinical trial. Tehran Univ Med J. 2014; 71(12):780-6.
10. Krymchantowski A, Barbosa J. Prednisone as initial treatment of analgesic-induced daily headache. Cephalalgia. 2000; 20(2):107–13. doi: 10.1046/j.1468-2982.2000.00028.x [DOI:10.1046/j.1468-2982.2000.00028.x]
11. Grazzi L, Andrasik F, Usai S, Bussone G. In-patient vs. day-hospital withdrawal treatment for chronic migraine with medication overuse and disability assessment: Results at one-year follow-up. Neurol Sci. 2008; 29(S1):161–3. doi: 10.1007/s10072-008-0913-6 [DOI:10.1007/s10072-008-0913-6]