Treatment of medication overuse headache – guideline of the EFNS headache panel

@article{Evers2011TreatmentOM,
  title={Treatment of medication overuse headache – guideline of the EFNS headache panel},
  author={Stefan Evers and Rh Jensen},
  journal={European Journal of Neurology},
  year={2011},
  volume={18}
}
Background:  Medication overuse headache is a common condition with a population‐based prevalence of more than 1–2%. Treatment is based on education, withdrawal treatment (detoxification), and prophylactic treatment. It also includes management of withdrawal headache. 
The Many Faces of Medication‐Overuse Headache in Clinical Practice
TLDR
The purpose of this review is to provide an overview of the literature on the management of MOH, and to highlight important considerations in the clinical evaluation of the MOH patient. Expand
Medication Overuse Headache
Medication overuse headache (MOH) affects between 1% and 2% of the general population but is present in up to 50% of patients seen in headache centers. There are currently no internationally acceptedExpand
Withdrawal failure in patients with chronic migraine and medication overuse headache
TLDR
Patients who were treated in day-hospital, those who recently attended ER for headache, and those with more than 69 headache/3 months, as well as to those with relevant symptoms of anxiety and depression who did not improve should be closely monitored to reduce likelihood of non-improvement after structured withdrawal. Expand
European Academy of Neurology guideline on the management of medication‐overuse headache
The frequent use of medication to treat migraine attacks can lead to an increase in migraine frequency and is called medication‐overuse headache (MOH).
Preventing and treating medication overuse headache
TLDR
A secondary headache is a worsening of a pre-existing headache owing to overuse of one or more attack-aborting or pain-relieving medications. Expand
Early management of patients with medication‐overuse headache: results from a multicentre clinical study
TLDR
This ancillary of the SAMOHA multicentre study aimed to assess any differences in phenotypic characteristics, type and amount of drugs overused, and comorbidities between patients with MOH who responded to simple advice and those who did not. Expand
Medication‐Overuse Headache: Protocols and Outcomes in 149 Consecutive Patients in a Tertiary Brazilian Headache Center
TLDR
Evaluation of outcome and treatment strategies in consecutive MOH patients from a tertiary center finds that medication‐overuse headache is a challenging clinical disorder often resulting in frustration for patients and physicians. Expand
Factors Associated With Medication‐Overuse Headache in Patients Seeking Treatment for Primary Headache
TLDR
Examination of the relative and combined associations of these factors with medication‐overuse headache in a sample of US adults seeking treatment for primary headache disorders found no clear link between these factors and disease progression. Expand
Disability, anxiety and depression in patients with medication‐overuse headache in primary care – the BIMOH study
TLDR
New data on headache disability and the Hospital Anxiety and Depression Scale (HADS) for MOH patients compared to population controls with and without chronic headache are presented and compared to previously published main outcome data. Expand
When tension headaches become chronic.
TLDR
Using a typical patient case scenario, this article illustrates evidence-based therapies that NPs can offer patients whose TTH has become chronic due to medication overuse. Expand
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References

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Reduction in medication‐overuse headache after short information. The Akershus study of chronic headache
Objective:  Our aim was to investigate the course of medication‐overuse headache in the general population and the effect of simple advice regarding medication overuse.
Management of medication overuse headache
  • Medicine
  • Drug and Therapeutics Bulletin
  • 2009
TLDR
Using some drugs both frequently and regularly can have a paradoxical effect, causing headaches rather than relieving them, and leading to medication overuse headache (MOH). Expand
Chronic daily headache with medication overuse: predictors of outcome 1 year after withdrawal therapy
TLDR
The aim was to identify baseline patient characteristics that might predict outcome after 1 year of withdrawal therapy. Expand
Practical management of medication-overuse headache.
Epidemiological studies suggest that medication-overuse as defined by the International Headache Society is extremely common in patients with chronic daily headache. If all medication-overuseExpand
Short‐term effectiveness of simple advice as a withdrawal strategy in simple and complicated medication overuse headache
TLDR
The aim of this study was to compare the effectiveness of intensive advice to withdraw the overused medication as a withdrawal strategy in patients with simple and complicated medication overuse headache. Expand
Ergotamine-induced headache associated with cluster headache
TLDR
In very few patients associations between ET-induced headache and cluster headache can be observed, and the authors' opinion that this syndrome is uncommon in patients suffering from cluster headache is agreed. Expand
Medication-overuse headache.
TLDR
Although the treatment regimen for MOH patients is straightforward and the outcomes are favorable, it is time to move forward and establish a predictive model for early recognition of patients at high risk, to intervene early and avoid development of chronic headache. Expand
Clinical features, pathophysiology, and treatment of medication-overuse headache
TLDR
As MOH can severely affect the quality of life of patients, it needs to be recognised early to enable appropriate treatment to be initiated and there is no clear evidence on which method of withdrawal therapy is the most efficacious. Expand
A narrative review on the management of medication overuse headache: the steep road from experience to evidence
TLDR
Treatment of MOH is a difficult challenge, but may be very rewarding, and neurologists need to know that the combination of education with a rational use of selected therapeutic strategies may be beneficial to people with chronic headache and help to relieve their suffering. Expand
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