Detoxification of medication-overuse headache by a multidisciplinary treatment programme is highly effective: A comparison of two consecutive treatment methods in an open-label design

Munksgaard, Signe Bruun; Bendtsen, Lars; Jensen, Rigmor

doi:10.1177/0333102412451363

Cited by 61 publications

(93 citation statements)

References 38 publications

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“…However, these results are not superior to detoxification without prophylactic medication in both simple and complicated MOH in the general population and neurologist setting, or in treatmentresistant MOH patients in a tertiary headache centre Rossi et al 2011;Munksgaard et al 2012]. Therefore, based on today's knowledge we suggest that initial withdrawal is the treatment of choice.…”

Section: Treatmentmentioning

confidence: 91%

Medication-overuse headache: epidemiology, diagnosis and treatment

Kristoffersen

Lundqvist

2014

Therapeutic Advances in Drug Safety

133

100

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Medication-overuse headache (MOH) is one of the most common chronic headache disorders and a public health problem with a worldwide prevalence of 1-2%. It is a condition characterized by chronic headache and overuse of different headache medications, and withdrawal of the overused medication is recognised as the treatment of choice. However, the strategy for achieving withdrawal is, at present, based on expert opinion rather than scientific evidence, partly due to the lack of randomised controlled studies. This narrative review investigates different aspects of epidemiology, diagnosis, risk factors and pathogenesis as well as management for MOH. We suggest that the first step in the treatment of MOH should be carried out in general practice and should focus primarily on detoxification. For most patients, both prevention and follow up after detoxification can also be performed in general practice, thus freeing resources for referral of more complicated cases to headache clinics and neurologists. These suffering patients have much to gain by an earlier treatment-focused approach lower down on the treatment ladder.

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Section: Treatmentmentioning

confidence: 91%

Medication-overuse headache: epidemiology, diagnosis and treatment

Kristoffersen

Lundqvist

2014

Therapeutic Advances in Drug Safety

133

100

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“…The proportion of patients with migraine or tension-type headache as their primary headache disorder differ depending on the classification used and at which health care level the investigation was conducted; 50%–70% have co-occurrence of migraine in population-based studies compared with 80%–100% for co-occurrence of migraine in studies from some headache centers 5,6,26,40,65,73…”

Section: Risk Factors For Mohmentioning

confidence: 99%

Medication-overuse headache: a review

Kristoffersen

Lundqvist²

2014

JPR

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Medication-overuse headache (MOH) is a worldwide health problem with a prevalence of 1%–2%. It is a severe form of headache where the patients often have a long history of headache and of unsuccessful treatments. MOH is characterized by chronic headache and overuse of different headache medications. Through the years, withdrawal of the overused medication has been recognized as the treatment of choice. However, currently, there is no clear consensus regarding the optimal strategy for management of MOH. Treatment approaches are based on expert opinion rather than scientific evidence. This review focuses on aspects of epidemiology, diagnosis, pathogenesis, prevention, and treatment of MOH. We suggest that information and education about the risk of MOH is important since the condition is preventable. Most patients experience reduction of headache days and intensity after successful treatment. The first step in the treatment of MOH should be carried out in primary care and focus primarily on withdrawal, leaving prophylactic medication to those who do not manage primary detoxification. For most patients, a general practitioner can perform the follow-up after detoxification. More complicated cases should be referred to neurologists and headache clinics. Patients suffering with MOH have much to gain by an earlier treatment-focused approach, since the condition is both preventable and treatable.

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“…Several studies have demonstrated a high success rate just by providing information or other simple actions (3)(4)(5). Even patients previously regarded as treatment resistant by specialists can be effectively treated by a structured, multidisciplinary treatment programme (2,6).…”

Section: Introductionmentioning

confidence: 99%