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Medication Overuse and Headache

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Handbook of Headache

Abstract

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.

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Authors and Affiliations

  1. Neurology Department, Athens Naval Hospital, 77A Vas. Sofias Avenue, 11521, Athens, Greece

    Dr. Dimos D. Mitsikostas MD, PhD

  2. College of Medicine, KAIMRC, King Saud Ben Abdulaziz University for Health Sciences, P.O. Box 22490; Mail Code 1515, 11426, Riyadh, Saudi Arabia

    Dr. Mohammed Al Jumah MD, FRCPC

Authors
  1. Dr. Dimos D. Mitsikostas MD, PhD
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  2. Dr. Mohammed Al Jumah MD, FRCPC
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Correspondence to Dimos D. Mitsikostas MD, PhD .

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Editors and Affiliations

  1. Department of Medical and Molecular Sciences, School of Health Sciences, Sapienza University of Rome, Rome, Italy

    Paolo Martelletti

  2. Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway

    Timothy J. Steiner

  3. Department of Neuroscience, Faculty of Medicine, Imperial College London, London, UK

    Timothy J. Steiner

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Mitsikostas, D.D., Al Jumah, M. (2011). Medication Overuse and Headache. In: Martelletti, P., Steiner, T.J. (eds) Handbook of Headache. Springer, Milano. https://doi.org/10.1007/978-88-470-1700-9_50

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  • DOI: https://doi.org/10.1007/978-88-470-1700-9_50

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