The Opioid Use In Turkish Patients With Episodic And Chronic Migraine

Introduction: Despite the inadequate evidence of efficacy and safety of the use of opioids for treatment of migraine, it has been reported that patients with severe migraine headaches are prescribed for opioids for pain relief. Drug interactions, abuse, and tolerance are some disadvantages of opioid therapy in migraine. There are studies evaluating opiophobia, prejudice against the use of opioid analgesics by patients and physicians, and the use of opioids for the management of cancer pain in Turkey. However, the opioid use in Turkish migraineurs has not been well documented. Objectives: The aim of this study was to assess the opioid therapy knowledge and use frequency among patients with episodic and chronic migraine. Methods: In this prospective cohort study, we enrolled consecutive migraine patients in our headache clinic during the study period. The diagnosis of migraine was made according to the International Classification of Headache Disorders 3rd edition beta version. The socio-demographic and clinical characteristics were recorded for all patients. Furthermore, patients were asked about the knowledge and use of opioids for migraine headache pain. Results: One hundred patients were enrolled, of which 69 were episodic migraine and 31 were chronic migraine. The mean age of patients was 41.41±12.14, 82 % were female. The duration of migraine was 12.3±10.37 years in episodic migraine and14.2±9.2 years in chronic migraine. Eighty-eight per cent of patients with chronic migraine were treated with at least one preventive treatment. For acute migraine attack treatment, paracetamol, nonsteroidal anti-inflammatory drugs, triptans, and antiemetics were taken in frequency order. All subjects reported that any kind of opioids was not offered or prescribed by general practitioners and neurologists for their headache pain. Besides this, only 8 (8%) patients declared that they heard the use of opioids for the treatment of migraine but they never consulted their doctors. Conclusion: Our results show that opioids are not preferred as an option for acute or preventive migraine treatment by Turkish migraineurs and their physicians.