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Medication-overuse headache: risk factors, pathophysiology and management
Hans-Christoph Diener1, Dagny Holle1, Kasja Solbach1
1Department of Neurology and Headache Center, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany.
Nature Reviews. Neurology
|September 13, 2016
Summary
Medication-overuse headache (MOH) affects about 1% of the population and is caused by excessive acute headache medication use. Treatment involves patient education, preventive medication, and detoxification, with a 50-70% success rate.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Medication-overuse headache (MOH) is a common secondary headache disorder.
- It arises from the excessive use of acute or symptomatic headache medications in individuals with a primary headache disorder.
- Prevalence is approximately 1% in the general population, significantly higher in chronic migraine sufferers.
Purpose of the Study:
- To review the epidemiology, risk factors, pathophysiology, prevention, and treatment of MOH.
- To outline a three-step treatment approach for managing MOH.
- To discuss factors influencing treatment success and relapse rates.
Main Methods:
- Literature review of epidemiology, risk factors, pathophysiology, prevention, and treatment strategies for MOH.
- Description of a phased treatment protocol including patient education, preventive therapy, and detoxification.
- Analysis of treatment success rates and relapse factors, including opioid overuse.
Main Results:
- MOH treatment success rates range from 50-70%.
- Patients with MOH associated with opioid overuse exhibit higher relapse rates.
- Patient education and consistent follow-up care are crucial for reducing relapse rates.
Conclusions:
- MOH is a prevalent condition linked to medication overuse in primary headache disorders.
- A structured, multi-step treatment approach is effective in managing MOH.
- Long-term patient education and follow-up are essential for sustained recovery and relapse prevention.
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