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Feature Article

Codeine and headache. ‘Doctor, I just need a script for my headaches’

Shuli Cheng, Elspeth Hutton

Figures

© deagreez/stock.adobe.com   model used for illustrative purposes only
© deagreez/stock.adobe.com model used for illustrative purposes only

Abstract

Harms associated with codeine-based treatments for headache include medication overuse headache and accidental overdose. Suggested management of patients with headache and codeine dependence includes education about harms of codeine, codeine withdrawal with bridging therapy if required, preventive medications and acute treatment for the primary headache disorder, and advice on lifestyle measures.

Key Points

  • Opioid use for episodic migraine is one of the greatest risks for transformation to chronic migraine.
  • Lifestyle measures are integral to chronic headache management.
  • Codeine is usually withdrawn gradually, with use of a bridging strategy if required.
  • Starting a preventive medication is usually recommended at the same time as withdrawing codeine.

Figures

© deagreez/stock.adobe.com   model used for illustrative purposes only
© deagreez/stock.adobe.com model used for illustrative purposes only