Selbstmedikation bei Migräne und beim Kopfschmerz vom Spannungstyp

Zusammenfassung

Die evidenzbasierte Leitlinie (S3-Leitlinie)über die Selbstmedikation bei Migräne und Spannungskopfschmerz der deutschen, österreichischen und schweizerischen Kopfschmerzgesellschaften und der DeutschenGesellschaft für Neurologie (DGN) richtet sich an in der Primärversorgung tätige Ärzte, anApotheker und Patienten. Trotz der gesundheitsökonomischen Bedeutung der Selbstmedikationfanden sich im internationalen Schrifttum keine vergleichbaren Leitlinien. Zuden bewerteten nicht rezeptpflichtigen Substanzenenthalten die Literaturbanken Medlineund Cochran 59 Studien, die in die Bewer-tung eingeschlossen werden konnten. DieWirksamkeit der Selbstmedikation bei einerMigräneattacke ist für folgende Substanzenoder Substanzkombinationen wissenschaftlichbelegt: Fixe Kombination aus Acetylsalicylsäure,Paracetamol und Koffe in sowie die Monotherapiemit Acetylsalicylsäure oder Ibuprofen oder Naratriptan oder Paracetamol oder Phenazon.Zur Selbstmedikation im Rahmen derMigräneprophylaxe kann die Wirksamkeit beikeiner der rezeptfrei erhältlichen Substanzenals wissenschaftlich eindeutig belegt eingestuftwerden. Zur Selbstmedikation bei Kopfschmerzenvom Spannungstyp können folgendefixe Kombinationen oder Monosubstanzenempfohlen werden: Fixe Kombination aus Acetylsalicylsäure,Paracetamol und Koffein bzw. aus Paracetamol und Koffe in sowie die Monother apienmit Ibuprofen oder Acetylsalicylsäureoder Diclofenac.

Summary

The actual evidence based guideline about self medication in migraine and tension type headache of the German, Austrian and Swiss headache societies and the German Society of Neurology is addressed to physicians engaged in the primary care as well as pharmacists and also patients. The guideline takes especially concern about the description of the used methodology of the selection process of the used literature and on which evidence there commendations are based. The following recommendations about self medication inmigraine attacks can be made: The effectiveness of the fixed combination of acetaminophen, acetylsalicylate and caffe in and the monotherapy with ibuprofen or naratriptaneor acetaminophen or phenacon are scientificallyproven; none of the substance used in the self medication in migraine prophylaxiscan be seen as proven effective. Concerningthe self medication in tension type headache the following option can be recommended:the fixed combination of acetaminophen, acetylsalicylic acid and caffein as well as thefixed combination of acetaminophen and caffeinas well as the monotherapy with ibuprofenor acetylsalicylic acid or diclofenac.

Schlüsselwörter

Migräne - Kopfschmerz vom Spannungstyp,Selbstmedikation - evidenzbasierte Behandlungsempfehlungen

Keywords

Migraine - tension-type headache - self medication,evidence based treatment recommendations.

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