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Medication-overuse headache: a narrative review
Helin Gosalia1, David Moreno-Ajona1,2, Peter J Goadsby3,4,5
1NIHR King's Clinical Research Facility, & SLaM Biomedical Research Centre, The Wolfson Sensory, Pain and Regeneration Centre (SPaRC), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
Abstract:
Medication-overuse headache (MOH), which potentially involves 1-2% of the population, is defined as a headache, on ≥ 15 days a month affected, along with overuse of one or other acute attack medications. MOH presents with significant challenges in the headache community, particularly in clinical settings raising various questions about its pathophysiology. Through a review of the current literature and our clinical experience, we have explored the mechanisms through which MOH may occur, provide an understanding of the current state of treatment and detail some possible views on the understanding and treatment of this condition. We evaluate the variations in treatment methods offered globally and understanding of the disorder. Above all interventions, patient education is crucial, which is underscored by an analysis of the academic publications. Given the condition is preventable, early intervention is imperative and patient awareness is highlighted as key. Globally, there is no uniform treatment methodology, which may be advantageous as approaches need to take local circumstances into account.
Insights
Medication-overuse headache (MOH), affecting 1-2% of the population, is a chronic headache condition caused by frequent acute medication use. Patient education and early intervention are crucial for prevention and management.
Area of Science:
- Neurology
- Headache Medicine
- Pharmacology
Background:
- Medication-overuse headache (MOH) affects 1-2% of the population, presenting significant clinical challenges.
- Defined by headaches on ≥15 days/month with overuse of acute medications, its pathophysiology remains incompletely understood.
- MOH poses diagnostic and therapeutic difficulties within the headache community.
Purpose of the Study:
- To explore the potential mechanisms underlying Medication-overuse headache (MOH).
- To provide an understanding of the current treatment landscape for MOH.
- To discuss current views on the understanding and management of MOH, highlighting global variations.
Main Methods:
- Review of current scientific literature.
- Analysis of clinical experience.
- Evaluation of global treatment variations and patient awareness strategies.
Main Results:
- Patient education emerged as a critical intervention for MOH management.
- Early intervention and patient awareness are highlighted as key preventative measures.
- No uniform global treatment methodology exists, necessitating localized approaches.
Conclusions:
- Understanding MOH pathophysiology is essential for effective treatment.
- Patient education and early intervention are paramount for preventing and managing MOH.
- Tailored, localized treatment strategies are necessary due to global variations in care.
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