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Chronic daily headache with medication overuse: predictors of outcome 1 year after withdrawal therapy

M G Bøe1, R Salvesen, A Mygland

  • 1Department of Neurology, Sørlandet Hospital, Kristiansand, Norway. magne.geir.boe@sshf.no

European Journal of Neurology
|February 25, 2009
PubMed

Insights

Withdrawal therapy for probable medication overuse headache shows variable success. Poor outcomes are linked to codeine use, poor sleep quality, and high bodily pain, suggesting sleep issues warrant attention.

Area of Science:

  • Neurology
  • Pain Medicine
  • Pharmacology

Background:

  • Medication overuse headache (MOH) is a common condition.
  • Withdrawal therapy is a primary treatment for MOH.
  • Predicting treatment success is crucial for patient management.

Purpose of the Study:

  • To prospectively evaluate withdrawal therapy outcomes in 80 patients with probable MOH.
  • To identify baseline patient characteristics predicting treatment success after one year.

Main Methods:

  • Patients were classified based on headache day improvement after withdrawal.
  • Outcome was measured as percentage improvement in headache days from baseline.
  • The SF-36 quality of life tool assessed pain and sleep quality.

Main Results:

  • 36% of patients achieved at least 50% improvement in headache days.
  • 64% had less than 50% improvement; 30% of these had less than 10% improvement.
  • Predictors of poor outcome included codeine-containing drug use, low sleep quality, and high bodily pain (SF-36).

Conclusions:

  • Withdrawal therapy for MOH yields varied results.
  • Codeine use, poor sleep, and high pain are associated with poorer outcomes.
  • Addressing sleep problems may improve withdrawal therapy success in MOH patients.
Abstract

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