Patterns of pharmacological treatment of patients with migraine, tension-type headache, and cluster headache in a large group of patients in Colombia, 2019

The objective was to determine the pharmacological treatment patterns of headache disorders in a Colombian population. Cross-sectional study. The dispensations of drugs for the management of tension-type headache, migraine, and cluster headache in the first trimester of 2019 were reviewed from a national medication dispensing database. Sociodemographic, diagnostic, and treatment variables (acute or prophylactic; concomitant drugs) were analyzed. During the study period, 7450 patients were identified: 68.5% with migraine, 25.1% with tension-type headache, and 6.4% with cluster headache. A total of 79.7% (n = 5937) were women, and the mean age was 38.6 +/- 14.7 years. The 87.8% (n = 6539) were prescribed drugs for acute pain management, mainly nonsteroidal anti-inflammatory drugs (n = 3559; 47.8%), acetaminophen (n = 3390; 45.5%), ergotamine (n = 2158; 29.0%), and opioids (n = 1750; 23.5%). The 50.3% (n = 3750) received at least one drug used for prophylaxis, mainly antidepressants (n = 1769, 23.7%), flunarizine (n = 927; 12.4%), and beta-blockers (n = 764; 10.3%). The main comedication was proton pump inhibitors (n = 921; 12.4%). Patients with tension-type headache, migraine, and cluster headache receive mainly medications for acute management, some with low therapeutic value or not recommended, such as opioids or ergotamine. Prophylactic management is mainly directed to migraines, although patients with other kinds of headache also used it, even though it was not indicated.