Лекарственно-индуцированная головная боль: анализ терапевтических стратегий

Ведение пациентов с лекарственно-индуцированной головной болью (ЛИГБ) – это нерешенная проблема современной неврологии в развитых странах, так как ЛИГБ становится частой причиной временной утраты трудоспособности и приводит к снижению качества жизни пациентов. Пациенты с первичной головной болью (например, страдающие головной болью напряжения или мигренью) нередко бесконтрольно применяют симптоматические препараты для купирования головной боли, что может привести к увеличению частоты и интенсивности ее эпизодов. В свою очередь, новые приступы головной боли провоцируют пациентов на употребление еще большего количества симптоматических препаратов, что приводит к формированию ЛИГБ.
В Международной классификации головных болей 3-го пересмотра ЛИГБ определяется как отдельная форма вторичной головной боли. На сегодняшний день нет единого мнения о тактике лечения и профилактики ЛИГБ. В статье обсуждаются различные подходы к профилактике и терапии ЛИГБ, их эффективность и целесообразность применения, а также факторы, влияющие на течение заболевания и возможные исходы. Особое внимание уделено ведению пациентов в период отмены, факторам риска рецидивов ЛИГБ и способам их предотвращения.

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