INPATIENT TREATMENT OF CHRONIC DAILY HEADACHE USING DIHYDROERGOTAMINE- A LONG-TERM FOLLOW-UP-STUDY

Background: The treatment of chronic daily headache (CDH) due to medic ation overuse remains a common and difficult problem. For selected pat ients refractory to outpatient management we have used a treatment pro tocol using dihydroergotamine (DHE) as introduced by Raskin, during a brief (typically 48 hours) in-patient stay. While many studies have do cumented the short-term efficacy of the DHE protocol, there are limite d data on its long-term effects. The purpose of this study was to eval uate the efficacy of the protocol on headache frequency and severity, analgesic use, absences from work, and quality of life, at three month s post treatment and the present time. Methods: A retrospective chart review of all patients admitted for the DHE protocol from 1991 to 1996 revealed 174 cases. Of these, 132 patients were interviewed by phone. Results: The DHE protocol was shown to decrease headache frequency, s everity, headache medication use, and absences from work both at three months and the time of interview. Conclusion: This study has the larg est patient base and the longest follow-up period for the use of DHE f or CDH. The results confirm that the DHE protocol is helpful in breaki ng the cycle of CDH, although the long-term outcomes of this study are more conservative than ether studies have reported.