2024-01-04 01:38:00
Thursday, January 4, 2024, 8:38 a.m.
‘Doctor Teerawat’ clarifies Why is it that the more you take medicine, the more headaches you get and the risk of MOH!?!?
4 January 2024 Prof. Dr. Teerawat Hemajutha, Head of the Emerging Disease Health Science Center Faculty of Medicine Chulalongkorn Hospital Posted a message via Facebook “Thirawat Hemachudha Thiravat Hemachudha” with the topic “The more you take medicine to relieve headaches, The more you get a headache” as follows…
The more headache medicine you take, the more headaches you’ll get.
We all may have experienced a headache at one time or another in our lives. When we have a headache, we take painkillers that we have at home, such as paracetamol, or buy medicine at a drug store to take. Are these pain relievers safe? And do these pain relievers, taken frequently, relieve the pain every time? And does it really cause more headaches than before?
It is well known that Painkillers we take It’s not completely safe if you take too much: paracetamol affects the liver and NSAIDs (such as ibuprofen, naproxen, etc.) are toxic to the kidneys. and cause gastric ulcers that can cause bleeding Or even ergot drugs that we have seen in the news that can cause blood loss in the hands or feet to the point of having to amputate the hands and feet. Moreover, these headache medicines If used too much or too frequently, it will still cause more headaches than before.
This kind of headache is called “Medication overuse headache” or “MOH”
#What is MOH disease and who has a chance of having MOH disease?
Medication Overuse Headache (MOH) usually occurs in patients who have a chronic headache disorder (such as migraine) and take too many pain relievers, causing recurring headaches. have more frequency or have a headache that has changed from before. As for the word “excessive” or “more than necessary,” it was found that if it is paracetamol or NSAID, it usually means using the drug for 15 days per month or more. But if it’s a pain reliever from the opioid group (opioid), ergot group, or triptan group, it means using the drug for 10 days or more per month. In addition, patients may easily observe additional symptoms that indicate a risk of MOH. Patients may take painkillers that have a shorter-lasting effect. Or after taking it the headache doesn’t go away.
#Why can pain relievers cause more headaches than before?
As for the mechanism of MOH, it is believed to be caused by the use of large amounts of painkillers for a considerable period of time. It will cause the brain to create more pain receptors. Therefore, when painkiller levels decrease, the brain automatically becomes more sensitive to pain even if there is no trigger for the headache.
#How is MOH disease treated and how should we use painkillers to be safe and not cause MOH disease?
Treatment for MOH is simple: stop taking the painkillers that cause MOH and see a doctor. To correct the original headache disease However, in the real world, this simple principle is difficult to achieve. This is because stopping painkillers often causes the patient to suffer from pain for a period of time.
Therefore, it would be better if we prevent MOH from occurring from the beginning. MOH can be prevented very easily by using painkillers correctly and appropriately. For example, in patients with migraines, painkillers should be used only while they are in pain. and use pain relievers early in each headache.
Most importantly, if migraine patients have unusually increased or more frequent headaches. This may lead to the use of painkillers that are close to the amount that causes MOH (as mentioned above). You will need to see a doctor to properly treat your migraines using “Headache control or headache prevention medicine,” which is a different type of medicine than painkillers. Using this headache medication can help reduce the severity and frequency of your headaches. As a result, the patient does not need to take a lot of painkillers.
In addition, behavioral changes to reduce the frequency of previous headaches, such as getting enough sleep exercise Avoiding triggers that cause headaches is also important
The fact that MOH is not widely known This may be the root cause of why many patients overuse painkillers without knowing that it can make their headaches more severe. So this year Especially in June, which is a month to raise awareness of headaches, especially migraines. The Headache Study Club Therefore, we planned a campaign to raise awareness of headaches caused by the use of painkillers more than necessary (MOH) at the same time with a simple slogan: “More pills, More pain” or “The more medicine you take, the more headaches”. To make the public, including medical personnel, more familiar and aware of MOH disease.
Dr. Prakit Anukunwittaya and Asst. Prof. Dr. Sek Tanprasertsuk Neurologist Headache Clinic Chulalongkorn Hospital, Thai Red Cross Society, Chairman of Educational Development Department and Chairman of Research Headache Study Club under the Neurology Association of Thailand
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