Medication overuse headache: clinical features, pathogenesis and management

2007 ◽  
Vol 68 (7) ◽  
pp. 449-460 ◽  
Author(s):  
James R. Couch ◽  
Marc E. Lenaerts
Keyword(s):  
Clinical Features ◽  
Medication Overuse ◽  
Medication Overuse Headache

scholarly journals Clinical features and outcomes of new daily persistent headache in patients in China and comparison with medication-overuse headache: A double-center retrospective study

2020 ◽  
Author(s):  
Huanxian Liu ◽  
Ye Ran ◽  
Liang Dang ◽  
Ruirui Yang ◽  
Shuping Sun ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Features ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Mainland China ◽  
Clinical Information ◽  
Trigger Factors ◽  
Male Predominance ◽  
Younger Age ◽  
Persistent Headache

Abstract Background: This study examined the clinical features and outcomes of NDPH patients and comparison with medication-overuse headache (MOH) in mainland China.Methods: This retrospective study observed patients with NDPH and medication-overuse headache (MOH) visiting two outpatient clinics between November 2011 and December 2019. Clinical information was collected and all patients were followed by telephone.Results: The study recruited 73 NDPH and 638 MOH patients. The NDPH patients included 39 males (53.4%) and 34 females (46.6%), with an average age of 37.4 years and average headache duration of 10.6 years. Headache-precipitating factors included infection (15.1%) and stress (30.1%). Compared to MOH patients, NDPH patients had a male predominance (53.4% vs. 22.6%, p<0.001), younger age of CDH onset (26.7±12.3 vs. 41.4±11.3 years, p<0.001), and longer duration of CDH (10.6±11.8 vs. 6.1±6.2 years, p=0.023). Of the 62 NDPH patients followed up for 31 months, on average, therapeutic responses were more effective in NDPH patients with trigger factors than in those without trigger factors (71.4% vs. 32.4%; p = 0.002); the odds ratio (OR) of an effective outcome was 5.25 (1.73-17.84, p = 0.005).Conclusions: NDPH is significantly different from MOH, with a male predominance, younger age of CDH onset, and longer duration of CDH. The presence of trigger factors is an independent predictor of better treatment effect in NDPH patients.

scholarly journals Clinical features of medication overuse headache following overuse of different acute symptomatic medications: A preliminary study

2021 ◽  
Author(s):  
Sun-Young Oh ◽  
Jin-Ju Kang ◽  
Hong-Kyun Park ◽  
Soo-Jin Cho ◽  
Min Kyung Chu
Keyword(s):  
Clinical Features ◽  
Clinical Characteristics ◽  
Medication Overuse ◽  
International Headache Society ◽  
Medication Overuse Headache ◽  
Observation Study ◽  
Cross Sectional ◽  
Daily Headache ◽  
Multiple Drugs ◽  
Acute Headache

Abstract Background Medication overuse headache (MOH) is a growing problem worldwide and is defined as daily or near-daily headache in patients with a primary headache disorder who overuse acute medications. There is debate about whether there are differences in the clinical features and risks of MOH induced by different drugs. Here we investigated the clinical characteristics of patients with MOH following overuse of different acute headache drugs such as triptans and other medications.Methods A multicenter cross-sectional observation study, REgistry for Load and Management of MEdicAtion OveruSE Headache (RELEASE), prospectively collected demographic and clinical data from 114 consecutive patients with MOH according to the International Headache Society criteria between May 2020 and January 2021. We calculated the mean duration until onset of MOH from chronic daily headache (MDMOH), mean monthly frequency of severe headache (MMFSH), mean monthly frequency of seeking medical services (MMFMedS), and mean monthly intake frequency (MMIF) as well as headache impact and neuropsychological tests in patients with MOH after overuse of acute headache drugs.Results A total of 105 eligible MOH patients was included in this study. The patients showed overuse of triptans (31/105, 29.5%), ergotamines (8/105, 7.6%), simple or combination analgesics (37/105, 35.2%), opioids (1/105, 0.9%), and combination of two of more drugs (28/105, 26.7%). The MDMOH was significantly longer for the analgesics group (10.6 years) than the ergotamines (4.1 years), triptans (4.3 years), or multiple drugs group (4.8 years) (p = 0.011, Kruskal–Wallis test). The MMFMedS was lower for the analgesics group (0.37 days per month) than the multiple drugs (0.85 days) or triptans (0.58 days) group (p = 0.008, Kruskal–Wallis test). The MMFSH was significantly lower in the triptans group (7.4 days per month) than in the analgesics (14.4 days) or multiple drugs group (13.7 days) (p = 0.005, Kruskal–Wallis test). The MMIF was higher in the multiple drugs group (25 days per month) than the triptans (18.1 days) or analgesics (19.5 days) group (p = 0.007, Kruskal–Wallis test).Conclusion Data from this prospective multicenter study suggest that the clinical characteristics of MOH depend on the type of overused symptomatic headache medications.

scholarly journals Clinical features and outcomes of new daily persistent headache in patients in China and comparison with medication overuse headache: a double-center retrospective study

Pain medicine ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 10-20
Author(s):  
Huanxian Liu ◽  
Ye Ran ◽  
Liang Dang ◽  
Ruirui Yang ◽  
Shuping Sun ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Features ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Mainland China ◽  
Clinical Information ◽  
Trigger Factors ◽  
Male Predominance ◽  
Younger Age ◽  
Persistent Headache

Background: This study examined the clinical features and outcomes of NDPH patients and comparison with medication-overuse headache (MOH) in Mainland China. Methods: This retrospective study observed patients with NDPH and medication-overuse headache (MOH) visiting two outpatient clinics between November 2011 and December 2019. Clinical information was collected and all patients were followed by telephone. Results: The study recruited 73 NDPH and 638 MOH patients. The NDPH patients included 39 males (39/73, 53.4%) and 34 females (34/73, 46.6%), with an average age of 37.4 years and average headache duration of 10.6 years. Headache-precipitating factors included infection (11/73, 15.1%) and stress (22/73, 30.1%). Compared to MOH patients, NDPH patients had a male predominance (53.4% vs. 22.6%, p<0.001), younger age of CDH onset (26.7±12.3 vs. 41.4±11.3 years, p<0.001), and longer duration of CDH (10.6±11.8 vs. 6.1±6.2 years, p=0.023). In 62 NDPH patients followed up for 31 months, on average, therapeutic responses were more effective in NDPH patients with trigger factors than in those without trigger factors (71.4% vs. 32.4%; p = 0.002); the odds ratio (OR) of an effective outcome was 5.25 (1.73–17.84, p = 0.005). Conclusions: NDPH is significantly different from MOH, with a male predominance, younger age of CDH onset, and longer duration of CDH. The presence of trigger factors is an independent predictor of better treatment effect in NDPH patients.

Analysis on the risk factors of medication-overuse headache in Chinese patients

2018 ◽  
Vol 48 ◽  
pp. 153-159
Author(s):  
Junxia Li ◽  
Chunfu Chen ◽  
Ligong Zhang ◽  
Xiaochen Cui ◽  
Chuanqiao Wei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Chinese Patients

Outcome of Medication Overuse Headache after Abrupt in-Patient withdrawal

Cephalalgia ◽  
2006 ◽  
Vol 26 (5) ◽  
pp. 589-596 ◽  
Author(s):  
G Relja ◽  
A Granato ◽  
A Bratina ◽  
RM Antonello ◽  
M Zorzon
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Primary Headache ◽  
Drug Intake ◽  
Patient Withdrawal ◽  
Abrupt Discontinuation ◽  
Medication Abuse ◽  
Daily Headache ◽  
Mean Time

One hundred and one patients suffering from chronic daily headache (CDH) and medication overuse were treated, in an in-patient setting, with abrupt discontinuation of the medication overused, intravenous hydrating, and intravenous administration of benzodiazepines and ademetionine. The mean time to CDH resolution was 8.8 days. The in-patient withdrawal protocol used was effective, safe and well tolerated. There was a trend for a shorter time to CDH resolution in patients who overused triptans ( P = 0.062). There was no correlation between time to CDH resolution and either the type of initial primary headache or duration of medication abuse, whereas time to CDH resolution was related to daily drug intake ( P = 0.01). In multiple regression analysis, daily drug intake, age and type of medication overused were independent predictors of time to CDH resolution. At 3-months' follow-up, no patient had relapsed and was again overusing symptomatic medications.

Discontinuation of Medication Overuse in Headache Patients: Recovery of Therapeutic Responsiveness

Cephalalgia ◽  
2006 ◽  
Vol 26 (10) ◽  
pp. 1192-1198 ◽  
Author(s):  
P Zeeberg ◽  
J Olesen ◽  
R Jensen
Keyword(s):  
Drug Withdrawal ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Headache Frequency ◽  
Female Ratio ◽  
Headache Centre ◽  
Before And After ◽  
Male Female Ratio ◽  
Few Data ◽  
Almost All

It is generally accepted that ongoing medication overuse nullifies the effect of prophylactic treatment, although few data support this contention. We set out to describe the treatment outcome in patients withdrawn from medication overuse and relate any improvement to a renewed effect of prophylaxis. For patients with probable medication-overuse headache (pMOH), treated and dismissed from the Danish Headache Centre in 2002 and 2003, we assed, from prospective headache diaries, the headache frequency before and after withdrawal of offending drugs and compared these frequencies with the headache frequency at dismissal. Among 1326 patients, 337 had pMOH. Eligible were 175, mean age 49 years, male/female ratio 1: 2.7. Overall, there was a 46% decrease in headache frequency from the first visit to dismissal ( P < 0.0001). Patients with no improvement 2 months after complete drug withdrawal ( N = 88) subsequently responded to pharmacological and/or non-pharmacological prophylaxis with a 26% decrease in headache frequency as measured from the end of withdrawal to dismissal ( P < 0.0001). At dismissal, 47% were on prophylaxis. Former non-responders to medical prophylaxis had a 49% decrease in headache frequency from first visit to dismissal ( P < 0.0001), whereas those who had never received prophylaxis had a 56% reduction ( P < 0.0001). This difference was not statistically significant ( P = 0.22). Almost all MOH patients benefit from drug withdrawal, either just from the withdrawal or by transformation from therapeutic non-responsiveness to responsiveness. According to the International Classification of Headache Disorders, 2nd edn, the MOH diagnosis requires improvement after drug withdrawal. Our data suggest that these diagnostic criteria are too strict.

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