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Management of medication overuse headache.
Domenico D'Amico1, Licia Grazzi1, Stewart J Tepper2
1UOC Neuroalgologia, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.
Handbook of Clinical Neurology
|February 2, 2024
Summary
Medication overuse headache (MOH) is a chronic condition caused by frequent use of acute migraine medications. Treatment involves withdrawal, prevention, and multidisciplinary approaches, with new therapies offering alternatives.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Medication overuse headache (MOH) transforms episodic migraines into chronic daily headaches.
- MOH poses a significant burden on patients and society due to its prevalence and complexity.
- Patients with MOH often present with comorbidities, complicating treatment strategies.
Approach:
- Review of current treatment strategies for MOH.
- Evaluation of educational, withdrawal, and prophylactic interventions.
- Assessment of multidisciplinary therapies including behavioral and neuromodulation options.
Key Points:
- Treatment requires patient education, medication withdrawal, and preventative strategies.
- Multidisciplinary approaches are crucial for managing complex MOH cases.
- Anti-CGRP monoclonal antibodies present a novel therapeutic option for select patients.
Conclusions:
- Integrated care programs are essential for effective MOH management.
- Guidance is provided for selecting patients who will benefit from coordinated programs.
- Future research should focus on optimizing treatment pathways for MOH.
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