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Medication overuse headache.
Signe B Munksgaard1, Rigmor H Jensen
1Danish Headache Centre, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.
Headache
|July 4, 2014
Summary
Medication overuse headache (MOH) is common in headache clinics. Simple detoxification and patient education can significantly reduce headache frequency, making MOH a treatable condition.
Area of Science:
- Neurology
- Pain Medicine
- Pharmacology
Background:
- Medication overuse headache (MOH) impacts 1-2% of the general population.
- MOH is diagnosed in up to 50% of patients presenting to headache centers.
- Current international treatment guidelines for MOH are lacking.
Purpose of the Study:
- To review current literature on the treatment and pathophysiology of MOH.
- To highlight the importance of recognizing and managing MOH.
- To emphasize the need for prevention strategies.
Main Methods:
- Literature review of MOH treatment.
- Analysis of MOH pathophysiology.
Main Results:
- Headache frequency reduction to episodic levels in over 50% of patients through detoxification and information.
- Approximately 50% of patients may not require prophylactic medication post-withdrawal.
- Altered pain perception in MOH is reversible, suggesting treatable central sensitization.
- High comorbidity with depression and anxiety may stem from reversible serotonin metabolism alterations.
Conclusions:
- MOH requires increased clinical focus as it is treatable and preventable.
- Consider MOH as a primary diagnostic step for all chronic headache patients.
- Population-level prevention campaigns are crucial for minimizing chronic pain disability from MOH.
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