Medication Overuse and Headache

  • Dimos D. Mitsikostas
  • Mohammed Al Jumah
Reference work entry


Medication-overuse headache (MOH) is a chronic, secondary headache disorder caused by the extensive overuse of all known symptomatic anti-headache drugs. Although its prevalence in the general population is limited to 1%, MOH has a major impact on the patient’s quality of life; thus, it creates a high economic burden on society. The ICHD-II guidelines classify MOH into eight subtypes based on the overused medication. Migraine is the most common primary headache complicated by medication overuse. Typically, headaches should resolve or revert to their previous pattern within 2 months after discontinuation of the overused medication, but revised criteria have been published. MOH is often comorbid with many affective disorders; therefore, its management requires a multidisciplinary therapeutic approach, including both pharmaceutical and behavioral treatments. Withdrawal of the overused medication is necessary to improve the headaches, yet MOH frequently recurs. To treat rebound headache from withdrawal, preventive therapy can be started prior to withdrawal of the overused medication. All medications used for the prevention of the primary headache disorders involved in MOH are also effective for the prevention of MOH after withdrawal. Additional treatment of all comorbid conditions, however, is also required.


Obsessive Compulsive Disorder Chronic Migraine Headache Disorder Medication Overuse Episodic Migraine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Lifting The Burden 2011

Authors and Affiliations

  1. 1.Neurology DepartmentAthens Naval HospitalAthensGreece
  2. 2.College of MedicineKAIMRC, King Saud Ben Abdulaziz University for Health SciencesRiyadhSaudi Arabia

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