Celecoxib versus prednisolone in medication overuse headache withdrawal treatment: double blind randomized clinical trial

Many drugs have been abused by patients for headache management. Celecoxib has not been abuse widely as a pain relief drug for headache. The aim of this study was comparison between celecoxib and prednisolone in bridge stage therapy following medication overuse headache. A double-blind randomized clinical trial was done in patients admitted to a private headache clinic in Tehran، Iran at 2012. Patients were selected with 18- 65 years old and 15 days headache per month at least. Prednisone was administered as a 75 mg/day، 50 mg/day، 30 mg/day، 25 mg/day and 10 mg/day dose، in 3 days interval. Celecoxib was administered as a 100mg dose three times per day (first 5 days)، twice per day (second 5 days) and one time per day (third 5 days). Headache time، headache intensity، headache duration، analgesic consumption due to severe headache and drug side effects was assessed. We used the visual analog scale to determine the severity of the pain. One hundred and three patients were enrolled in two groups: celecoxib (53 cases) and prednisolone (50 cases). Twenty and one men and eighty and one women with a mean age of 33. 62±9. 65 years participated in the study. The maximum fre-quency for headache time in the celecoxib group was 1-4 hours (19 cases) and more than four hours (19 cases). In the prednisolone group the maximum frequency for headache time was more than 4 hours (28 cases) (P=0. 149). The frequency of side effects of prednisolone and celecoxib groups were 42% and 18. 9%، respectively (Relative Risk=2. 2، P=0. 011). The most common side effects in both groups were weakness and lethargy. Considering the positive effect of both drugs in reducing patients'' head-ache during withdrawal، celecoxib compared with prednisolone has better efficacy and fewer side effects.