Evaluation of self-medication prevalence, diagnosis and prescription in migraine in Kerman, Iran.

OBJECTIVE To investigate different diagnosis aspects, prescribed drugs and self-medications of migraine in Iran. METHODS We selected 210 migraineurs from high school and university students in Kerman, Iran over a period of 6 months in 2002 by multistage randomized screening based on the International Headache Society criteria. We classified them into 2 groups on the basis of whether they had consulted a physician or not. We then evaluated the physician prescriptions, and prevalence of self-medications. RESULTS Only 49% of migraineurs consulted a physician, and only 53% were correctly diagnosed by physicians according to the International Headache Society criteria. Our study shows that 69% of general practitioners diagnoses were wrong. In spite of indications for prophylactic treatment, it was not prescribed in 76% of the patients, and 50% of the general practitioners prescribed it without any indications. Furthermore, 91% of patients used self-medication; Acetaminophen and Codeine were the most common. CONCLUSION General practitioners` misdiagnosis and mismanagement of the migraineurs, and easy access to various drugs in Iran, have led to a high rate of self-medication. Self-medication with Codeine, with regard to its side effects, such as increase of secondary headaches and dependency is the major problem. Consequently, medical education systems, physician reevaluating methods, and the concept of self-medication among patients have to be revised.