[Headache from overuse of medication].
Medication overuse headache (MOH) occurs in about 1% of the general population. A marked increase of its prevalence has to be expected in the future, since more and more adolescents are subject to medication overuse. The revised International Classification of Headache Disorders contains detailed diagnostic criteria for headache due to particular groups of substances. They help recognizing MOH due to ergots, triptans, analgesics and opioids, and to distinguish them from each other MOH almost exclusively occurs in patients with a long history of migraine or chronic tension type headache, which suggests some genetic disposition. The treatment of choice of MOH is withdrawal of the causing drug. Long-term treatment for headache is ineffective during medication overuse. Relapse rate is variable depending on the substance overused, and may be considerable. Therefore, prophylaxis in patients with migraine or chronic tension type headache who do not yet suffer from MOH, is essential.
Meienberg
O
O
Praxis für Neurologie, Binningen. otmar.meienberg@hin.ch
D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D000818:Animals; D003937:Diagnosis, Differential; D004878:Ergotamine / Q000008:administration & dosage / Q000009:adverse effects; D051271:Headache Disorders, Secondary / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D038801:International Classification of Diseases; D008881:Migraine Disorders / Q000188:drug therapy; D051381:Rats; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000209:etiology; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis*; D018781:Tension-Type Headache / Q000188:drug therapy; D014363:Tryptamines / Q000008:administration & dosage / Q000009:adverse effects
D000700:Analgesics; D000701:Analgesics, Opioid; D014363:Tryptamines; D004878:Ergotamine