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Medication Overuse Headache: an Updated Review and Clinical Recommendations on Management
Megan A Hird1, Claire H Sandoe2,3
1Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada.
Current Neurology and Neuroscience Reports
|June 4, 2023
Summary
Medication overuse headache (MOH) affects many with primary headache disorders. Management involves medication withdrawal, preventative therapies, and patient-centered care.
Area of Science:
- Neurology
- Clinical Medicine
Background:
- Medication overuse headache (MOH) is a common complication in patients with primary headache disorders.
- Understanding its epidemiology and risk factors is crucial for effective management.
Purpose of the Study:
- To provide an updated review of MOH epidemiology, risk factors, and current treatment strategies.
- To offer recommendations for the clinical management of MOH.
Main Methods:
- Review of recent large clinical trials and emerging evidence.
- Analysis of preventative therapies and management approaches.
Main Results:
- MOH prevalence is between 0.5% and 7.2%, with risk factors including female sex, lower socioeconomic status, psychiatric conditions, and substance use disorders.
- Preventative therapies, including anti-CGRP mAbs, candesartan, topiramate, amitriptyline, and onabotulinumtoxinA, are supported by recent clinical trials.
- Effective MOH management necessitates a multifaceted, patient-centered approach.
Conclusions:
- A comprehensive strategy combining patient education, behavioral interventions, medication withdrawal, and preventative therapy is essential for managing MOH.
- Emerging treatments show promise, reinforcing the need for updated clinical guidelines.
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