The National Institute of Health and Clinical Excellence, otherwise known as NICE , has urged GPs to consider whether painkillers could be causing headaches in their patients. Painkillers could be a possible cause of migraine.
The body, which provides advice and guidance on the use of medicines and medical technologies within the NHS, advises that GPs and other healthcare professionals should consider the possibility of ‘medication overuse’ in patients taking painkillers – particularly those listed below – for up to half of the days in a month over a period of 3 months.
- Triptans, opioids, ergots or combination analgesic medications on 10 days per month or more, or
- Paracetamol, aspirin and an NSAID [non-steroidal anti-inflammatory drug, e.g. ibuprofen], either alone or any combination, on 15 days per month or more.
Professor Martin Underwood, a GP and primary care researcher who chaired the development of the new guidance, said: “We have effective treatments for common headache types. However, taking these medicines for more than ten or fifteen days a month can cause medication overuse headache, which is a disabling and preventable disorder.”
“Patients with frequent tension-type headaches or migraines can get themselves into a vicious cycle, where their headaches are getting increasingly worse, so they take more medication which makes their pain even worse as they take more medication.”
The information which considers cause of migraine, published on the NICE website, also states that correct diagnosis of the type of headache is crucial, since different headaches require different treatments.
The following key facts are given by NICE:
- More than 10 million people in the UK experience regular or frequent headaches, making them one of the most common health complaints
- Headache accounts for 1 in 25 (4%) of primary care consultations and up to 30% of neurology out-patient appointments. Current practice suggests that 97% of people with headache are managed in primary care
- More than 100,000 people are absent from work or school because of migraines every working day – this totals around 25 million days a year
- Cluster headache is a type of primary headache, which typically causes intense pain around one eye. It presents in clusters for a month or two at around the same time of year. Around 1 in 1,000 people are believed to experience these at some point in their lives. Over-the-counter medications tend not to ease symptoms, but there are several treatments (including preventative options) recommended in the new NICE guideline
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