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Improvement of Decreased Critical Flicker Frequency (CFF) in Headache Patients With Drug Abuse After Successful Withdrawal
Authors:Peter Schnider  MD  Joachim Maly  PhD  Josef Grünberger  PhD  Susanne Aull  MD  Karl Zeiler  MD  Peter Wessely  MD
Institution:From the Clinics for Neurology (Drs. Schnider, Maly, Aull, Zeiler, and Wessely) University of Vienna, Austria.and; Psychiatry (Dr. Grünberger) University of Vienna, Austria.
Abstract:A considerable proportion of headache patients fulfill the criteria of "drug abuse" (definition according to the International Headache Society IHS] criteria). These patients exhibit markedly reduced vigilance and continuous performance, as shown by the results of critical flicker frequency (CFF) analysis.
The present study deals with the question whether this impairment of vigilance and continuous performance is reversible. Forty-eight headache patients with drug abuse were investigated three times by means of CFF analysis: immediately before (A), immediately after (B), and 3 weeks after having finished (C) inpatient drug withdrawal.
Immediately after withdrawal, a significant decrease of headache intensity was observed. The CFF values, however, remained unchanged at a depressed level, probably due to withdrawal medication and the initial sedative side effects of thymoleptic agents (given as prophylaxis).
Three weeks after withdrawal, however, the CFF values were significantly improved, and were now within a range not far from the normal values known from a healthy general population. Thus, even after many years of drug abuse, headache patients have a good chance to improve their vigilance and continuous performance and to reach normal or close to normal levels.
Keywords:migraine  tension-type headache  drug abuse  withdrawal therapy  critical flicker frequency (CFF)
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