- Patients with medication-overuse headache (MOH) who stopped acute analgesics or migraine medications altogether had a bigger decrease in MOH-related disability and reported an improved QoL much sooner than those who just restricted their medication use to twice a week.
Why this matters
- The recommended treatment for MOH is to stop the overuse of medication, but there is no consensus on the best approach for withdrawal.
- This prospective outpatient study randomly allocated 72 MOU patients with primary migraine and/or tension-type headache to 2 months either without acute analgesics/migraine medications (program A) or with acute medications restricted to 2 days/week (program B).
- Disability and headache burden assessed by Headache Under-Response to Treatment index (HURT), and QoL by EUROHIS-QOL.
- Funding: Danish Medical Society Copenhagen; TrygFoundation.
- At 12 months' follow-up, reduction in disability (25% vs 7%; P=.027) and headache burden (33% vs 3%; P=.005) was significantly higher in program A vs program B.
- QoL increased by 8% in both programs (P=.30).
- At 2-month follow-up, QoL increased significantly more in program A vs program B (P=.006).
- Most complicated patients needing in-patient treatment not included.
- A number of patients did not complete all questionnaires.
Coauthored with Antara Ghosh, PhD