Current pain and headache reports
-
Curr Pain Headache Rep · Aug 2009
ReviewRadiation, chemotherapy, and symptom management in cancer-related cognitive dysfunction.
Patients with cancer are concerned about their ability to interact with friends and family and to perform activities associated with daily living. The combined effects of the disease process, its treatment with surgery, radiation, and chemotherapy, and the medications used to manage symptoms may all impact cognitive function. Minimizing the effect of each treatment modality on cognitive processing requires an understanding of how these treatment modalities may impact cognition.
-
Curr Pain Headache Rep · Aug 2009
ReviewOveruse of acute migraine medications and migraine chronification.
Among individuals with episodic migraine, the influence of excessive acute medication use on the development of chronic migraine depends upon within-person characteristics (eg, headache frequency), class of drug, and frequency of medication use. Available data suggest that opioids induce migraine chronification (progression), and the effect is dose dependent (critical dose around 8 days of exposure per month) and more pronounced in men. Barbiturates also induce migraine progression, and the effect is dose dependent (critical dose around 5 days of exposure per month) and more pronounced in women. ⋯ NSAIDs protect against migraine progression unless individuals have 10 or more headache days per month (when they become inducers, rather than protective). Finally, caffeine-containing over-the-counter products increase risk of progression. While we await randomized trials, these findings should inform the choice of acute migraine treatments with the goal of reducing the risk of migraine progression to chronic migraine.