- Medication overuse headaches (MOHs) do not seem to respond to many rescue and prophylactic treatments.
Why this matters
- MOHs are extremely distressing to patients, so avoiding them is critical.
- However, this meta-analysis shows that treatment, whether prophylactic or rescue, is often ineffective.
- Clinicians may want to consider reducing acute treatments where possible.
- 16 studies were considered in review, totaling 1105 patients.
- Prednisone was not found to be significantly different from placebo or celecoxib in rescue trials.
- No significant differences between inpatient and outpatient treatments.
- No significant differences between valproate and topiramate in prophylaxis trials.
- Prophylaxis trials showed a significant difference between amitriptyline and placebo.
- Some benefit for 10 d less of acute medication, but the quality of evidence was low.
- Systematic review and meta-analysis of RCTs, including crossover studies and cluster-randomized trials for MOHs in adults.
- Funding: None disclosed.
- Researchers did not look for gray literature.
- Most trials were small.