Headache Relief
by Lawrence Robbins, MD, and Halleh Akbarnia, MD
 Medication options for patients with severe,
refractory, chronic daily headache (CDH) remain limited. The choices include opioids;
amphetamines; monoamine oxidase inhibitors (MAOIs), with or without tricyclic
antidepressants, beta-blockers, or calcium blockers; daily triptans; or dihydroergotamine
(DHE). The use of daily opioids for nonmalignant pain, such as CDH, remains somewhat
controversial. Previous studies have demonstrated that in a small number of refractory
headache patients, opioids can result in a greatly enhanced quality of life.
While the short-acting opioids often lead to rebound headaches and overuse, this is not
observed as often with the longer-acting ones. This study compares three different
long-acting opioids in severe, chronic, daily headache patients: sustained-release (SR)
morphine sulfate; methadone; and controlled-release (CR) oxycodone.
Please refer to the May/Jun 2001 issue for the complete text. In the event you need to order a back issue, please click here.
— May/Jun 2001
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