Impact of self-medication on chronic daily headache

Introduction: Chronic daily headache is a frequent condition in the general population. A high percentage of patients have an abusive consumption of analgesics that makes the headache worse and may also carry the risk of multiple pathologies produced by these drugs. It is defined as the presence of headache continuously or almost continuously for at least 15 days a month, for a period of at least three months. This work was carried out through a detailed search of medical articles and clinical trials published between 2010 and 2023. The precise pathophysiological mechanisms that lead to the development of headache due to analgesic abuse are largely unknown, however, multiple factors may be involved, including genetic predisposition, sensitization within the trigeminal system, abnormal processing of cortical pain and decreased anti-nociceptive activity of the supraspinal structures. NSAIDs are the first step in the pharmacological treatment of headaches and chronic use of these drugs can cause a paradoxical worsening of the headache and the development of analgesic-induced headache, which is currently the most prevalent secondary headache worldwide.