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Medikamentenmissbrauch und Medikamenten-induzierter Kopfschmerz


"In double-blind, placebo-controlled trials, the 5- HT1B/D agonist sumatriptan 6 mg injected subcutaneously is effective in about 75% of all cluster headache patients (i.e. pain free within 20 min) [38–40]. Doses less than 6 mg have also been described to be effective [41]. It is safe with no evidence of tachyphylaxis or rebound in most of the patients, even after frequent use [42–44], although recent evidence suggests that cluster headache patients with migraine may experience rebound headache [45]."

38. The Sumatriptan Cluster Headache Study Group. Treatment of acute cluster headache with sumatriptan. New England Journal of Medicine 1991; 325: 322–326.

39. Ekbom K, Monstad I, Prusinski A, Cole JA, Pilgrim AJ, Noronha D. Subcutaneous sumatriptan in the acute treatment of cluster headache: a dose comparison study. The Sumatriptan Cluster Headache Study Group. Acta Neurologica Scandinavica 1993; 88: 63–69.

40. Stovner LJ, Sjaastad O. Treatment of cluster headache and its variants. Current Opinion in Neurology 1995; 8: 243–247.

41. Gregor N, Schlesiger C, Akova-Ozturk E, Kraemer C, Husstedt IW, Evers S. Treatment of cluster headache attacks with less than 6 mg subcutaneous sumatriptan. Headache 2005; 45: 1069–1072.

42. Wilkinson M, Pfaffenrath V, Schoenen J, Diener HC, Steiner TJ. Migraine and cluster headache – their management with sumatriptan: a critical review of the current clinical experience. Cephalalgia 1995; 15: 337– 357.

43. Ekbom K, Krabbe A, Micelli G, et al. Cluster headache attacks treated for up to three months with subcutaneous sumatriptan (6 mg). Sumatriptan Cluster Headache Long-term Study Group. Cephalalgia 1995; 15: 230–236.

44. Go¨ bel H, Lindner V, Heinze A, Ribbat M, Deuschl G. Acute therapy for cluster headache with sumatriptan: findings of a one-year long-term study. Neurology 1998; 51: 908–911.

45. Paemeleire K, Bahra A, Evers S, Matharu M, Goadsby P. Medication-overuse headache in cluster headache patients. Neurology 2006; 67: 109–113.

46. Dodick DW, Martin VT, Smith T, Silberstein S. Cardiovascular tolerability and safety of triptans: a review of clinical data. Headache 2004; 44(Suppl. 1): S20–S30.

Quelle: http://www.efns.org/files/guideline_49.pdf

--Friedrich 12:35, 17. Sep. 2007 (CEST)

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