Abrupt outpatient withdrawal of medication in analgesic-abusing migraineurs

46 migraineurs with secondary chronic daily headache were treated for medication abuse as outpatients by abrupt withdrawal of the offending drugs. The patients were supported with adequate explanation of the disorder, regular follow-up, amitriptyline (10 mg at night), and naproxen (500 mg) for relief of headache symptoms. By 6 months of follow-up 37 patients had relief from chronic headaches, and analgesic intake had become intermittent and appropriate to the original occasional migraine episodes. 6 had substantially reduced analgesic intake, but headache severity was unchanged; 2 had not managed to reduce intake and headache was unchanged; and 1 patient withdrew after the first visit.