The Importance of Psychiatric Comorbidity in Headache Disorders in Neurology(<Special Issue>A Psychosomatic Study of Headache)

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  • 神経内科における頭痛の心身医学的問題(<特集>頭痛の心身医学)
  • 神経内科における頭痛の心身医学的問題
  • シンケイ ナイカ ニ オケル ズツウ ノ シンシン イガクテキ モンダイ

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Abstract

The importance of psychiatric comorbidity (such as depression and anxiety) in headache disorders especially primary headache has long been recognized in comparison with other physical disorders. There is a growing body of evidence that these psychiatric comorbidities share diverse epidemiological properties, pathophysiological mechanisms, and treatment response. The prevalence of psychiatric comorbidities is high in patients with medication-overuse headache (MOH). Usually antidepressant is used for treatment of depression and anxiety disorders. Furthermore, antidepressant including tricyclic antidepressant (TCA) is used for treatment of various pain disorders. As for the amitriptyline in particular, preventive evidence of a chronic headache is established, furthermore we can expect efficacy of other type antidepressants. We must choose the regimen that is optimal for every patient in consideration of compliance and side effects.

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