Abstract
Medication-overuse headache (MOH) is an endemic and disabling neurological condition that affects between 1-2 % of the general population, which helps chronify a previous underlying headache, usually migraine. It is defined as a headache that appears 15 or more days a month in a patient with pre-existing primary headache as a consequence of habitual abuse of acute or symptomatic headache medication (for 10 or more, or 15 or more days a month, depending on the drug) in a period of more than three months. Usually, but not always, remit when stopping medication abuse. Treatment requires several steps: education, withdrawal of excess medication, detoxification, and initiation of prophylactic management.
References
Russell MB. Epidemiology and management of medication-overuse headache in the general population. Neurol Sci. 2019;40 Supp 1:23-6.
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
Negro A, Curto M, Lionetto L, Guerzoni S, Pini LA, Martelletti P. A critical evaluation on MOH current treatments. Curr Treat Options Neurol. 2017;19(9):32.
Katsarava Z, Schneeweiss S, Kurth T, Kroener U, Fritsche G, Eikermann A, et al. Incidence and predictors for chronicity of headache in patients with episodic migraine. Neurology. 2004;62(5):788-90.
Westergaard ML, Hansen EH, Glumer C, Olesen J, Jensen RH. Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates: a systematic review. Cephalalgia Int J Headache. 2014;34(6):409-25.
Kristoffersen ES, Lundqvist C. Medication-overuse headache: epidemiology, diagnosis and treatment. Ther Adv Drug Saf. 2014;5(2):87-99.
Thorlund K, Sun-Edelstein C, Druyts E, Kanters S, Ebrahim S, Bhambri R, et al. Risk of medication overuse headache across classes of treatments for acute migraine. J Headache Pain. 2016;17(1):107.
Hagen K, Albretsen C, Vilming ST, Salvesen R, Gronning M, Helde G, et al. A 4-year follow-up of patients with medication-overuse headache previously included in a randomized multi-centre study. J Headache Pain. 2011;12(3):315-22.
Cevoli S, Sancisi E, Grimaldi D, Pierangeli G, Zanigni S, Nicodemo M, et al. Family history for chronic headache and drug overuse as a risk factor for headache chronification. Headache. 2009;49(3):412-8.
Vandenbussche N, Laterza D, Lisicki M, Lloyd J, Lupi C, Tischler H, et al. Medication-overuse headache: a widely recognized entity amidst ongoing debate. J Headache Pain. 2018;19(1):50.
Bendtsen L, Munksgaard S, Tassorelli C, Nappi G, Katsarava Z, Lainez M, et al. Disability, anxiety and depression associated with medication-overuse headache can be considerably reduced by detoxification and prophylactic treatment. Results from a multicentre, multinational study (COMOESTAS project). Cephalalgia Int J Headache. 2014;34(6):426-33.
Srikiatkhachorn A, le Grand SM, Supornsilpchai W, Storer RJ. Pathophysiology of medication overuse headache-an update. Headache J Head Face Pain. 2014;54(1):204-10.
Coppola G, Curra A, Di Lorenzo C, Parisi V, Gorini M, Sava SL, et al. Abnormal cortical responses to somatosensory stimulation in medication-overuse headache. BMC Neurol. 2010;10:126.
Fumal A, Laureys S, Di Clemente L, Boly M, Bohotin V, Van-denheede M, et al. Orbitofrontal cortex involvement in chronic analgesic-overuse headache evolving from episodic migraine. Brain J Neurol. 2006;129 Pt 2:543-50.
Grazzi L, Chiapparini L, Ferraro S, Usai S, Andrasik F, Mandelli ML, et al. Chronic migraine with medication overuse pre-post withdrawal of symptomatic medication: clinical results and FMRI correlations. Headache. 2010;50(6):998-1004.
Riederer F, Marti M, Luechinger R, Lanzenberger R, von Meyenburg J, Gantenbein AR, et al. Grey matter changes associated with medication-overuse headache: correlations with disease related disability and anxiety. World J Biol Psychiatry. 2012;13(7):517-25.
Chen PK, Wang SJ. Medication overuse and medication overuse headache: risk factors, comorbidities, associated burdens and nonpharmacologic and pharmacologic treatment approaches. Curr Pain Headache Rep. 2019;23(8):60.
Hagen K, Linde M, Steiner TJ, Stovner LJ, Zwart JA. Risk factors for medication-overuse headache: an 11-year follow-up study. The Nord-Trondelag Health Studies. Pain. 2012;153(1):56-61.
Chiang CC, Schwedt TJ, Wang SJ, Dodick DW. Treatment of medication-overuse headache: A systematic review. Cephalalgia. 2016;36(4):371-86.
Andrasik F, Grazzi L, Usai S, Buse DC, Bussone G. Non-pharmacological approaches to treating chronic migraine with medication overuse. Neurol Sci. 2009;30 Suppl 1:S89-93.
Grazzi L, Andrasik F, Usai S, Bussone G. In-patient vs. day-hospital withdrawal treatment for chronic migraine with medication overuse and disability assessment: results at one-year follow-up. Neurol Sci. 2008;29 Suppl 1:S161-163.
Diener HC, Dodick D, Evers S, Holle D, Jensen RH, Lipton RB, et al. Pathophysiology, prevention, and treatment of medication overuse headache. Lancet Neurol. 2019;18(9):891-902.
de Goffau MJ, Klaver ARE, Willemsen MG, Bindels PJE, Verhagen AP. The Effectiveness of treatments for patients with medication overuse headache: a systematic review and meta-analysis. J Pain. 2017;18(6):615-27.
Negro A, Curto M, Lionetto L, Martelletti P. A two years open-label prospective study of onabotulinumtoxinA 195 U in medication overuse headache: a real-world experience. J Headache Pain. 2015;17:1.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.