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

Abstract

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.

• Authors: S D Silberstein, D C McCrory
• Journal: Headache (Headache) 2001 Nov-Dec Vol. 41 Issue 10 Pg. 953-67 ISSN: 0017-8748 [Print] United States
• PMID: 11903523 (Publication Type: Journal Article, Review)

Chemical References

• Analgesics
• Barbiturates
• Drug Combinations
• butalbital

Topics

• Acute Disease
• Analgesics (therapeutic use)
• Barbiturates (pharmacology, therapeutic use)
• Drug Combinations
• Headache (drug therapy)
• Humans
• Migraine Disorders (drug therapy)
• Tension-Type Headache (drug therapy)
• Treatment Outcome