Medication overuse headache

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By Zaza Katsarava MD and Hans-Christoph Diener MD

Medication overuse headache is a chronic headache that occurs in people with migraine or tension-type headache following overuse of any kind of acute headache drugs. Patients should be treated in a multidisciplinary setting that involves complete withdrawal of overused medication followed by preventive therapy, education, and psychological support. In this clinical article, Dr. Zaza Katsarava and Dr. Hans-Christoph Diener, both of the University of Essen in Germany, provide an update on the pathophysiology, clinical aspects, and treatment strategies of this headache type.

Key points

  • Overuse of any kind of acute headache or migraine drugs can lead to the development of medication overuse headache.
  • People suffering from primary headache, such as migraine or tension-type headache, are at higher risk to develop chronic headache following the overuse of acute headache drugs.
  • Treatment of medication overuse headache requires a multidisciplinary setting and includes education of patients, withdrawal as an initial step, and initiation of preventive treatment.