Butalbital in the Treatment of Headache: History, Pharmacology, and Efficacy
Article first published online: 26 JAN 2004
Headache: The Journal of Head and Face Pain
Volume 41, Issue 10, pages 953–967, December 2001
How to Cite
Silberstein, S. D. and McCrory, D. C. (2001), Butalbital in the Treatment of Headache: History, Pharmacology, and Efficacy. Headache: The Journal of Head and Face Pain, 41: 953–967. doi: 10.1046/j.1526-4610.2001.01189.x
- Issue published online: 28 JUN 2008
- Article first published online: 26 JAN 2004
- Accepted for publication July 30, 2001.
- acute medication;
- drug overuse;
- daily headache
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.