Family Practice
THE JOURNAL OF FAMILY PRACTICE Arianne P.Verhagen, PhD, Is any one analgesic Léonie Damen, PhD, Marjolein Y.Berger, MD, PhD, Jan Passchier, PhD, superior for episodic Vivian Merlijn, PhD, and Bart W. Koes, PhD tension-type headache? Department of General Practice, Erasmus Medical This systematic review suggests good tolerance Centre, Rotterdam, The Netherlands. of any given agent may be the deciding factor From the Department of General Practice (APV, LD, MYB, BWK) and the Practice recommendation drug that is well tolerated by a patient is a Department of Medical T Though all non-narcotic analgesics have reasonable basis for selection. Ibuprofen, Psychology and Psychotherapy equivalent efficacy against tension-type therefore, generally may be advocated. (JP, VM) ® Dowden Health Media headache, ibuprofen’s generally favorable When acetaminophen is preferred. Our side-effect profile makes it a reasonable results suggest NSAIDs might be more firCopyrightst choice. For personal use onlyeffective than acetaminophen for TTH. However, because NSAIDs are allergenic hereas quantitative and qualita- for some people, and they must not be tive analyses of 41 randomized used in association with anticoagulants,2 W controlled trials (RCTs) strongly acetaminophen might be an alternative in suggests that all types of NSAIDs are more these situations. When giving acetamino- effective than placebo (>50% pain relief) phen, the dose of the medication might be against an acute episode of tension-type important due to a possible dose-response headache (TTH), the evidence also shows relationship. that no single nonsteroidal anti-inflamma- tory drug (NSAID) is more effective than Why this review was needed another in this setting.
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