你為什么會(huì)出現(xiàn)反彈性頭痛?

你為什么會(huì)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(kāi)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(dāng)你所依賴(lài)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(wàn)人因過(guò)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(dāng)疼痛無(wú)法緩解時(shí)，他們就會(huì)服用另一種藥物，從而導(dǎo)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(lái)時(shí)，而不是一周兩到三次需要止痛藥的頭痛。對(duì)許多人來(lái)說(shuō)，這是一種新的慢性疼痛，而且沒(méi)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(shí)還結(jié)合物理或行為療法和預(yù)防性藥物治療，有時(shí)被稱(chēng)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(yù)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(huì)有過(guò)度使用藥物引起頭痛的風(fēng)險(xiǎn)。有時(shí)，病人可能會(huì)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(dǎo)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(gè)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(xué)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(shuō)：“多年來(lái)，歐洲的指導(dǎo)方針一直在建議停藥，最近一次是從2020年5月開(kāi)始公布的。”他是一項(xiàng)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(shí)上，醫(yī)生們一直在爭(zhēng)論是否有必要采取任何預(yù)防性治療來(lái)幫助病人擺脫藥物依賴(lài)。

What causes a MOH?

什么導(dǎo)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(huì)導(dǎo)致反復(fù)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(guó)偏頭痛基金會(huì)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(huì)導(dǎo)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(duì)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(huì)引發(fā)藥物過(guò)量的頭痛。那只是一杯咖啡加上一杯可樂(lè)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(huì)導(dǎo)致記憶問(wèn)題、注意力難以集中、抑郁、焦慮、易怒、坐立不安和惡心。