Treatment‐Resistant Medication Overuse Headache Can Be Cured

Abstract

Patients with medication overuse headache previously regarded treatment-resistant benefit considerably from multidisciplinary treatment in a structured detoxification program with close follow-up.

Medication-overuse headache: a review

“…Two Italian studies in neurology settings reported that 78%–92% of patients with simple MOH and 60% of those with complicated MOH became free of chronic headache and medication-overuse 2 months after receiving simple advice 133,147,148. Even previously treatment-resistant MOH patients from a tertiary headache center experienced lasting improvement after withdrawal of medication 69. Based on our clinical experience, most patients overusing simple analgesics as well as codeine-containing combination analgesics and triptans manage abrupt withdrawal without tapering.…”

A Short Review on Medication-Overuse Headache

“…It must be considered that this study had the advantage of a patient population not overusing opioid or barbiturates, which often predicts better treatment outcome figures [2,6]. We believe that the results would have being less favorable if these medications were the rule.…”

“…The inclusion criteria were 15 or more headache days per month from a primary headache diagnosis of migraine or chronic migraine and overuse of symptomatic medications. The existence of previous attempts of treatment or detoxification was not an inclusion limitation as usually happened with most of previous studies [2,6,10,11].…”

“…It also may lead to the reduction of headache frequency as well [5,7,10,11]. Additionally, even among patients who succeed in detoxification, there may be a high percentage of those who will relapse within the first year of follow-up [5,6]. Moreover, It is still uncertain whether patients who had daily headache would present a better treatment outcome and experience a higher reduction of headache frequency in comparison to those who had near-daily headache, but few studies suggest that daily headache patients will perform better [12].…”

“…Although it is highly prevalent and promotes considerable burden, little evidence is available regarding treatment, which is mostly based on bias or expert opinion recommendations [4,5]. However, the suspension of overused medications, treatments using multidisciplinary approaches as well as absence of psychiatric comorbidities and overuse of drugs other than opioids are favorable outcome factors [4][5][6][7].…”