medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2015-17-62-67medsovet-428Research ArticleНЕВРОЛОГИЯNEUROLOGYЛекарственно-индуцированная головная боль: эпидемиология, диагностика и лечениеMedication-induced headache: pathogenesis, diagnosis and treatmentЧечетЕ. А.ChechetE. A.noemail@neicon.ruТабееваГ. Р.TabeyevaG. R.noemail@neicon.ruПервый Московский государственный медицинский университет им. И.М. СеченоваРоссияFirst Moscow State Medical University named after I.M. SechenovRussian Federation2015301220150176267Copyright © Чечет Е.А., Табеева Г.Р., 20152015Чечет Е.А., Табеева Г.Р.Chechet E.A., Tabeyeva G.R.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/428

Лекарственно-индуцированная головная боль (ЛИГБ) - одна из самых распространенных форм хронической головной боли (ГБ), ведение пациентов с ЛИГБ остается актуальной проблемой современной медицины. ЛИГБ характеризуется ГБ свыше 15 дней в месяц на протяжении более 3 мес. в сочетании с избыточным применением лекарственных препаратов (Лп) для облегчения ГБ. Изложены эпидемиологические данные, современные диагностические критерии, факторы риска, патофизиология и лечение ЛИГБ. Обсуждаются риски и причины рецидивов, прогноз заболевания. Единственной эффективной стратегией ведения пациентов признается отмена препарата, вызвавшего ЛИГБ. Для облегчения ГБ и различных симптомов пациентам могут быть предписаны различные симптоматические препараты, за исключением класса ЛП, вызвавших ЛИГБ. Отдельное внимание уделено препарату Экседрин, комбинированному анальгетику, хорошо зарекомендовавшему себя в острую фазу отмены ЛП. Большинству пациентов возможно проведение детоксикационной и профилактической терапии на амбулаторном уровне. Важную роль играют образовательные программы, посвященные аспектам формирования ЛИГБ и трансформации ГБ в хроническую.

Medication-induced headache (MIH) is one of the most common forms of chronic headache (HA), management of patients with MIH remains an urgent problem of the modern healthcare. MIH is defined as HA lasting for more than 15 days per month for over 3 months against a background of excessive use of drugs for relief of HA. Epidemiological data, current diagnostic criteria, risk factors, pathophysiology and treatment of MIH are described. Risks and causes of recurrence, and prognosis of the disease are described. The only effective strategy for the management of patients is withdrawal of the drug that caused MIH. For the purpose of managing MIH and its different symptoms, a variety of symptomatic drugs with the exception of the class of drugs that caused MIH may be prescribed. The focus is on Excedrin - a combination analgesic which proved effective in the acute phase of drug withdrawal. For most patients, detoxification and preventive therapy on an outpatient basis may be feasible. An important role belongs to educational programs devoted to the aspects of MIH formation and transformation of HA to chronic.

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The authors declare that there are no conflicts of interest present.