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Butalbital in the treatment of headache: history, pharmacology, and efficacy.

Author(s): Silberstein SD, McCrory DC

Affiliation(s): Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

Publication date & source: 2001-11, Headache., 41(10):953-67.

Publication type: Review

Analgesics containing butalbital compounded with aspirin, acetaminophen, and/or caffeine are widely used for the treatment of migraine and tension-type headache. The butalbital-containing compounds are efficacious in placebo-controlled trials among patients with episodic tension-type headaches. Despite their frequent clinical use for migraine, they have not been studied in placebo-controlled trials among patients with migraine. Barbiturates can produce intoxication, hangover, tolerance, dependence, and toxicity. Butalbital can result in intoxication that is clinically indistinguishable from that produced by alcohol. Butalbital-containing analgesics can produce drug-induced headache in addition to tolerance and dependence. Higher doses can produce withdrawal syndromes after discontinuation. Butalbital-containing analgesics may be effective as backup medications or when other medications are ineffective or cannot be used. Because of concerns about overuse, medication-overuse headache, and withdrawal, their use should be limited and carefully monitored.

Page last updated: 2006-01-31

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