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Intra‐patient variability of the hair levels of pain medications in chronic migraine patients – a pilot study
Author(s) -
Ferrari Anna,
Rustichelli Cecilia,
Baraldi Carlo,
Vandelli Daniele,
Verri Patrizia,
Marchesi Filippo,
Licata Manuela
Publication year - 2019
Publication title -
drug testing and analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.065
H-Index - 54
eISSN - 1942-7611
pISSN - 1942-7603
DOI - 10.1002/dta.2560
Subject(s) - medicine , migraine , hair analysis , chronic pain , medical prescription , chronic migraine , anesthesia , pharmacology , physical therapy , alternative medicine , pathology
Monitoring of prescription pain medications is strongly recommended, considering their abuse liability. We used hair analysis for monitoring pain medications in 12 women with chronic migraine and drug overuse. Hair samples were collected at baseline and after 4 and 8 months and analyzed by liquid chromatography−electrospray tandem mass spectrometry (LC‐ESI‐MS/MS). Intra‐patient variability of the hair‐level‐to‐dose ratio was <20% in most cases. The hair analysis detected changes in the dose taken by the same patient over time, both occasionally and chronically. The agreement between the changes in hair drug levels and those of taken doses was excellent. Therefore, hair analysis appeared advantageous for long‐term monitoring of pain medications, which is otherwise difficult to determine in conventional matrices. In the same sample, multiple medications could be simultaneously determined, and with three samples, nine months of therapy were objectively documented.