Headache disorders: differentiating and managing the common subtypes.
- Fayyaz Ahmed
- British journal of pain
The frequent use (> 15 times/month) of medication for the treatment of acute migraine attacks may cause medication overuse headache. This kind of headache can be caused by the intake of combination analgesics, opioids, ergot alkaloids, and triptans. The delay between first intake and daily headache is shortest for triptans (1 to 2 years), longer for ergots (3 years), and longest for analgesics (5 years). Treatment includes drug withdrawal followed by structured acute therapy and initiation of migraine prophylactic treatment.