Evidence map›Paper›PMID 32691178›Full record

ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2021

Low-dose methadone for refractory chronic migraine accompanied by medication-overuse headache: a prospective cohort study.

Silvia Benemei, Chiara Lupi, Francesco De Cesaris, Niccolò Lombardi, Alessandra Bettiol, Alberto Chiarugi, Pierangelo Geppetti, Valentina Galli, Chiara Pracucci, Brunella Occupati and 1 more

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In one paragraph

Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 50% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Silvia BenemeiHeadache Center, Careggi University Hospital, Florence, Italy. silvia.benemei@unifi.it.ORCID http://orcid.org/0000-0001-6316-430X
Chiara LupiHeadache Center, Careggi University Hospital, Florence, Italy.
Francesco De CesarisHeadache Center, Careggi University Hospital, Florence, Italy.
Niccolò LombardiNEUROFARBA Department, Toxicology Unit, Careggi University Hospital, University of Florence, Florence, Italy.
Alessandra BettiolNEUROFARBA Department, Toxicology Unit, Careggi University Hospital, University of Florence, Florence, Italy.
Alberto ChiarugiDepartment of Health Sciences, Headache Center, Careggi University Hospital, University of Florence, Florence, Italy.
Pierangelo GeppettiDepartment of Health Sciences, Headache Center, Careggi University Hospital, University of Florence, Florence, Italy.
Valentina GalliToxicology Unit, Careggi University Hospital, Florence, Italy.
Chiara PracucciToxicology Unit, Careggi University Hospital, Florence, Italy.
Brunella OccupatiToxicology Unit, Careggi University Hospital, Florence, Italy.
Guido MannaioniNEUROFARBA Department, Toxicology Unit, Careggi University Hospital, University of Florence, Florence, Italy.
Azienda Ospedaliero-Universitaria Careggi · ITUniversity of Florence · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesA refractory chronic migraine (RCM) accompanied by medication-overuse headache (MOH) is an extremely disabling disease. Evidence suggests that in selected patients, chronic opioids may be a valuable therapeutic option for RCM. The aim of the present study was to evaluate the effectiveness and safety of prophylaxis with low-dose methadone (LDM) in patients affected by RCM with continuous headache and MOH.

methodsA prospective cohort study was performed between May 2012 and November 2015 at the Headache Center and Toxicology Unit of the Careggi University Hospital. Eligible patients were treated with prophylactic LDM and followed up for 12 months. Headache exacerbations, pain intensity, use of rescue medications, and occurrence of adverse drug reactions (ADRs) were recorded.

resultsThirty patients (24 females, median age 48 years) were enrolled. Nineteen (63%) patients dropped out, mainly because of early ADRs (n = 10), including nausea, vomiting, and constipation. At last available follow-up, LDM was associated with a significant decrease in the number of headache attacks/month (from a median of 45 (interquartile range 30-150) to 16 (5-30), p < 0.001), in pain intensity (from 8.5 (8-9) to 5 (3-6), p < 0.001), and in the number of rescue medications consumed per month (from 95 (34-240) to 15 (3-28), p < 0.001). No misuse or diversion cases were observed.

conclusionLDM could represent a valuable and effective option in selected patients affected by RCM with continuous headache and MOH, although the frequency of early ADRs poses major safety concerns. Randomized controlled trials are needed to confirm the efficacy and safety of LDM prophylaxis.

Indexed as

Headache Disorders, SecondaryMigraine DisordersFemaleHeadacheHumansMethadoneMiddle AgedProspective StudiesMethadoneClinical practiceMedication overuseMethadoneMigraineProspective cohort studyRefractory headache

Identifiers

PMID32691178
PMCPMC7870632
OpenAlexW3043635336

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.