你为什么会出现反弹性头痛?

你为什么会出现反弹性头痛?

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.

你的头又开始疼了。你又拿起止痛药吃，却发现它们不再起作用了。你可能患有MOH(一种药物滥用引起的头痛)，当你所依赖的缓解头痛的药物突然变成了敌人。

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.

全球约有6000万人因过度使用药物而患上头痛。它通常发生在偏头痛、丛集性头痛或紧张型头痛患者身上，这些患者使用的药物不起作用。

When the pain doesn't ease, they take another pill, thus setting the scene for what is often known as a "rebound" headache.

当疼痛无法缓解时，他们就会服用另一种药物，从而导致所谓的“反弹性”头痛。

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.

现在MOH患者几乎每天都头痛，通常是在醒来时，而不是一周两到三次需要止痛药的头痛。对许多人来说，这是一种新的慢性疼痛，而且没有什么灵丹妙药可以治愈它。

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，戒断疗法是治疗这种疾病的唯一方法，有时还结合物理或行为疗法和预防性药物治疗，有时被称为“桥梁疗法”。

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.

这些预防性药物治疗包括抗惊厥药、抗抑郁药、β-受体阻滞剂和钙通道阻滞剂，这些药物可能有助于控制停药后的疼痛，而不会有过度使用药物引起头痛的风险。有时，病人可能会注射肉毒杆菌或旨在阻止偏头痛的抗体。

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.

但并非总是如此。例如，在丹麦，指导方针建议完全停药，在提供其他选择之前完全停止任何止痛药两个月。

"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.

哥本哈根大学丹麦头痛中心主任、头痛和神经痛教授里格莫尔·詹森博士说：“多年来，欧洲的指导方针一直在建议停药，最近一次是从2020年5月开始公布的。”他是一项新研究的主要作者，研究这些建议是否正确。

In fact, doctors have long debated whether any preventative treatments were necessary to help patients wean off medications.

事实上，医生们一直在争论是否有必要采取任何预防性治疗来帮助病人摆脱药物依赖。

What causes a MOH?

什么导致了MOH(药物滥用引起的头痛)?

Just how much pain medication will cause a rebound headache depends on the medicine.

究竟多少止痛药会导致反复性头痛取决于药物。

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.

根据美国偏头痛基金会的研究，非处方止痛药，如阿司匹林、扑热息痛、布洛芬、萘普生和消炎痛，如果每月服用15天或以上，会导致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、阿司匹林和对乙酰氨基酚的药物后，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.

仅仅200毫克的咖啡也会引发药物过量的头痛。那只是一杯咖啡加上一杯可乐和一块纯巧克力。

It's not just pain in the head either. Often MOH can cause memory issues, difficulty concentrating, depression, anxiety, irritability, restlessness and nausea.

这不仅仅是头痛。MOH通常会导致记忆问题、注意力难以集中、抑郁、焦虑、易怒、坐立不安和恶心。