Medication overuse headache

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By Zaza Katsarava 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 of the University of Essen in Germany provides 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.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited