你為什么會出現(xiàn)反彈性頭痛?

你為什么會出現(xiàn)反彈性頭痛?

Your head is pounding yet again. You grab another round of pain meds, only to find they no longer work. You may be suffering from a MOH -- a medication overuse headache -- brought on when the very medications you relied on for relief suddenly become the enemy.

你的頭又開始疼了。你又拿起止痛藥吃，卻發(fā)現(xiàn)它們不再起作用了。你可能患有MOH(一種藥物濫用引起的頭痛)，當你所依賴的緩解頭痛的藥物突然變成了敵人。

Some 60 million people around the world suffer from headaches brought on by the overuse of medication. It typically happens to people who suffer from migraines, cluster headaches or tension-type headaches who are using medications that don't work.

全球約有6000萬人因過度使用藥物而患上頭痛。它通常發(fā)生在偏頭痛、叢集性頭痛或緊張型頭痛患者身上，這些患者使用的藥物不起作用。

When the pain doesn't ease, they take another pill, thus setting the scene for what is often known as a "rebound" headache.

當疼痛無法緩解時，他們就會服用另一種藥物，從而導致所謂的“反彈性”頭痛。

Instead of a headache that might call for pain medications two or three times a week, people with MOH now have a headache nearly every day, typically upon awakening. For many, this is a new level of chronic pain -- and there's no miracle pill to fix it.

現(xiàn)在MOH患者幾乎每天都頭痛，通常是在醒來時，而不是一周兩到三次需要止痛藥的頭痛。對許多人來說，這是一種新的慢性疼痛，而且沒有什么靈丹妙藥可以治愈它。

Withdrawal therapy is currently the only treatment for this disorder, sometimes combined with physical or behavioral therapy and preventative medicine treatments, sometimes called "bridge therapies."

目前，戒斷療法是治療這種疾病的唯一方法，有時還結(jié)合物理或行為療法和預防性藥物治療，有時被稱為“橋梁療法”。

Those preventative medicine treatments include anticonvulsants, antidepressants, beta blockers and calcium channel blockers that might help control withdrawal pain without risking medication overuse headaches. At times a patient may be given injections of Botox or antibodies designed to thwart migraines.

這些預防性藥物治療包括抗驚厥藥、抗抑郁藥、β-受體阻滯劑和鈣通道阻滯劑，這些藥物可能有助于控制停藥后的疼痛，而不會有過度使用藥物引起頭痛的風險。有時，病人可能會注射肉毒桿菌或旨在阻止偏頭痛的抗體。

But not always. In Denmark, for example, guidelines suggest a complete withdrawal, totally discontinuing any pain medications for two months before other options are provided.

但并非總是如此。例如，在丹麥，指導方針建議完全停藥，在提供其他選擇之前完全停止任何止痛藥兩個月。

"Withdrawal has been recommended for years in European Guidelines, including the most recent published from May 2020," said Dr. Rigmor Jensen, a professor of headache and neurological pain who directs the Danish Headache Center at the University of Copenhagen, and is lead author on a new study to see if those recommendations were right.

哥本哈根大學丹麥頭痛中心主任、頭痛和神經(jīng)痛教授里格莫爾·詹森博士說：“多年來，歐洲的指導方針一直在建議停藥，最近一次是從2020年5月開始公布的。”他是一項新研究的主要作者，研究這些建議是否正確。

In fact, doctors have long debated whether any preventative treatments were necessary to help patients wean off medications.

事實上，醫(yī)生們一直在爭論是否有必要采取任何預防性治療來幫助病人擺脫藥物依賴。

What causes a MOH?

什么導致了MOH(藥物濫用引起的頭痛)?

Just how much pain medication will cause a rebound headache depends on the medicine.

究竟多少止痛藥會導致反復性頭痛取決于藥物。

According to the American Migraine Foundation, over-the-counter pain relievers, such as aspirin, acetaminophen, ibuprofen, naproxen and indomethacin, can cause MOH when used 15 or more days per month.

根據(jù)美國偏頭痛基金會的研究，非處方止痛藥，如阿司匹林、撲熱息痛、布洛芬、萘普生和消炎痛，如果每月服用15天或以上，會導致MOH。

It will only take about 10 days of use for medications that combine caffeine, aspirin and acetaminophen to contribute to a MOH.

服用混合了咖啡因、阿司匹林和對乙酰氨基酚的藥物后，只需10天左右就能引起MOH。

Just 200 milligrams of coffee will also trigger a medication overdose headache. That's just one cup of coffee combined with a coke and a plain chocolate bar.

僅僅200毫克的咖啡也會引發(fā)藥物過量的頭痛。那只是一杯咖啡加上一杯可樂和一塊純巧克力。

It's not just pain in the head either. Often MOH can cause memory issues, difficulty concentrating, depression, anxiety, irritability, restlessness and nausea.

這不僅僅是頭痛。MOH通常會導致記憶問題、注意力難以集中、抑郁、焦慮、易怒、坐立不安和惡心。