[Medication-overuse headache]

Ned Tijdschr Geneeskd. 2018:162:D1749.
[Article in Dutch]

Abstract

- Medication-overuse headache is a highly prevalent disorder with a major impact on the quality of life.- Medication-overuse headache is defined as headache on ≥ 15 days per month with overuse of acute headache medication for ≥ 3 months. We talk about overuse in case of intake of simple analgesics on ≥ 15 days per month or triptans or combinations of analgesics on ≥ 10 days per month.- The underlying type of headache is usually migraine or tension-type headache.- One of the possible underlying mechanisms of medication-overuse headache is changed sensitivity as a consequence of central sensitisation.- The initial treatment is detoxification of the headache medication. The preferred detoxification method is outpatient, abrupt withdrawal of all acute-headache medication and caffeine-containing products. Essential for successful detoxification is education about the reasons for detoxification, the expected course and the subsequent treatment.

MeSH terms

  • Acute Disease
  • Analgesics / administration & dosage
  • Analgesics / adverse effects*
  • Behavior Therapy
  • Central Nervous System Sensitization
  • Headache Disorders, Secondary / chemically induced*
  • Headache Disorders, Secondary / physiopathology
  • Headache Disorders, Secondary / therapy*
  • Humans
  • Migraine Disorders / drug therapy*
  • Patient Education as Topic
  • Tension-Type Headache / drug therapy*

Substances

  • Analgesics