Penatalaksanaan Medication-overuse Headache - Artini, Ni Made Yuli; Adnyana, I Made Oka (PT. Kalbe Farma Tbk., 2014)
Medication-overuse Headache (MOH) adalah nyeri kepala kronik akibat penggunaan berlebihan analgesik, triptan, atau kombinasi obat nyeri kepala lain. Patofisiologi MOH belum jelas, diduga ada peranan faktor genetik, fisiologi dan regulasi reseptor, serta faktor psikologis. Tujuan pengobatan MOH adalah mengurangi frekuensi dan atau keparahan nyeri kepala, mengurangi konsumsi obat akut, memperbaiki respon terhadap obat akut dan obat preventif, mencegah kecacatan dan memperbaiki kualitas hidup. Langkah-langkah pencegahan termasuk membatasi konsumsi obat, menghindari kafein dan obat-obatan mengandung kafein atau kodein. Profilaksis dini mungkin diperlukan. Penanganan MOH meliputi edukasi pasien serta withdrawal obat. Pasien diikuti secara teratur untuk mencegah kambuh, terutama di tahun pertama setelah withdrawal.Medication-overuse Headache (MOH) is a chronic headache caused by overuse of analgesics, triptans, or other drugs. Pathophysiology of MOH is unknown, presumably influenced by genetics, physiology and regulation of the receptor, as well as psychological factors. The goal of MOH treatment is to reduce the frequency and/or severity of headache, to reduce acute drug consumption, to improve response to acute and preventive treatment, to prevent disability and improve quality of life. Measures to prevent MOH include limiting drugs consumption, avoiding caffeine and medications containing caffeine or codeine. Early prophylaxis either with medication or behavioral therapy may be necessary. Management consists of patient education and drug withdrawal. Patients should be followed regularly, especially in the first year, to prevent relapse.