title: Medication overuse headache: rates and predictors for relapse in a 4-year prospective study.
abstract: We present a prospective 4-year follow-up study of 96 patients with medication overuse headache following withdrawal. Complete datasets were available from 85 patients (89%) 6 months, from 79 patients (82%) 1 year and from 75 patients (78%) 4 years after withdrawal. Twenty-six patients (31%) relapsed within the first 6 months after withdrawal. The number of relapses increased to 32 (41%) 1 year and to 34 (45%) 4 years after withdrawal. The 4-year relapse rate was lower in migraine than in tension-type headache (32% vs. 91%, P<or=0.001) and combination of migraine and tension-type headache (32% vs. 70%, P<or=0.027) and also lower in patients overusing triptans than analgesics (21% vs. 71%, P<or=0.001). The study suggests that the majority of relapses occur within the first year after withdrawal and that the long-term success of withdrawal depends on the type of primary headache and the type of overused medication.
authors.affiliation: Department of Neurology, University Hospital Essen, Essen, Germany.
authors.forename: Z
authors.initials: Z
authors.lastname: Katsarava
authors.forename: M
authors.initials: M
authors.lastname: Muessig
authors.forename: A
authors.initials: A
authors.lastname: Dzagnidze
authors.forename: G
authors.initials: G
authors.lastname: Fritsche
authors.forename: H C
authors.initials: HC
authors.lastname: Diener
authors.forename: V
authors.initials: V
authors.lastname: Limmroth
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000009:adverse effects* / Q000627:therapeutic use; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D020773:Headache Disorders / Q000139:chemically induced* / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D055502:Secondary Prevention
chemical_list: D000700:Analgesics