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Behavioural intervention in medication overuse headache: A concealed double-blind randomized controlled trial.
Judith A Pijpers1, Dennis A Kies1,2, Erik W van Zwet3
1Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands.
European Journal of Neurology
|January 22, 2022
Summary
Intensive behavioral therapy for medication overuse headache can reduce acute medication use shortly after withdrawal. Further research is needed to determine if these benefits can be sustained long-term.
Area of Science:
- Neurology
- Behavioral Science
Background:
- Medication overuse headache (MOH) is a common neurological disorder.
- It has a significant biobehavioral component, suggesting behavioral interventions may help reduce medication overuse.
Purpose of the Study:
- To assess the efficacy of a behavioral intervention during medication withdrawal therapy for MOH.
- To compare maximal versus minimal behavioral intervention by a headache nurse.
Main Methods:
- A concealed, double-blind, randomized controlled trial was conducted.
- 179 patients with MOH received either maximal (intensive contact) or minimal (short contact) behavioral intervention during 12 weeks of withdrawal.
- Endpoints included successful withdrawal and monthly acute medication use.
Main Results:
- Withdrawal was achieved by 93% in the maximal group and 86% in the minimal group at Week 12.
- At Week 24, the maximal intervention group reported significantly fewer days of acute medication use (mean difference = -2.23).
- No significant difference in monthly migraine days was observed between groups.
Conclusions:
- Behavioral intervention by a headache nurse offers modest benefits for reducing acute medication use in MOH during and shortly after therapy.
- Prolonged effects may require extended intervention periods.
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