Life (Jul 2024)

Acute and Preventive Treatment of COVID-19-Related Headache: A Series of 100 Patients

  • David García-Azorín,
  • Claudia García-Ruiz,
  • Álvaro Sierra-Mencía,
  • Yésica González-Osorio,
  • Andrea Recio-García,
  • Ana González-Celestino,
  • Cristina García-Iglesias,
  • Álvaro Planchuelo-Gómez,
  • Ana Echavarría Íñiguez,
  • Ángel L. Guerrero-Peral

DOI
https://doi.org/10.3390/life14070910
Journal volume & issue
Vol. 14, no. 7
p. 910

Abstract

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To describe the need and effectiveness of acute and preventive medications in a series of 100 consecutive patients referred due to COVID-19-related headaches. Patients were aged 48.0 (standard deviation (SD): 12.4), 84% were female, and 56% had a prior history of headache. The most common headache phenotype was holocranial (63%), frontal (48%), pressing (75%), of moderate intensity (7 out of 10), and accompanied by photophobia (58%). Acute medication was required by 93%, with paracetamol (46%) being the most frequently used drug, followed by ibuprofen (44%). The drugs with the highest proportion of a 2 h pain-freedom response were dexketoprofen (58.8%), triptans (57.7%), and ibuprofen (54.3%). Preventive treatment was required by 75% of patients. The most frequently used drugs were amitriptyline (66%), anesthetic blockades (18%), and onabotulinumtoxinA (11%). The drugs with the highest 50% responder rate were amitriptyline (45.5%), mirtazapine (50%), and anesthetic blockades (38.9%). The highest 75% responder rate was experienced following onabotulinumtoxinA (18.2%). In conclusion, most patients required acute medication, with triptans and non-steroidal anti-inflammatory drugs achieving the best responses. Three-quarters of patients required preventive medication. The most frequently used drug was amitriptyline, which obtained the best results. In some treatment-resistant patients, anesthetic blockades and onabotulinumtoxinA were also beneficial.

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