Chronic daily headache with medication overuse: predictors of outcome 1 year after withdrawal therapy.
OBJECTIVE
We examined prospectively the results of withdrawal therapy in 80 patients with probable medication overuse headache. The aim was to identify baseline patient characteristics that might predict outcome after 1 year (end of study).


METHODS
We classified patients according to results of withdrawal therapy measured as the improvement of headache days (HD) from baseline to end of study.


RESULTS
Thirty-six per cent (29/80) had at least 50% improvement. Sixty-four per cent (51/80) had <50% improvement, and among these, 30% (24/80) had <10% improvement. The following baseline characteristics were associated with poor outcome of withdrawal therapy: use of codeine-containing drugs, low self-reported sleep quality, and high self-reported bodily pain as measured by the quality of life tool SF-36.


CONCLUSIONS
Before suggesting withdrawal therapy, one should probably pay more close attention to sleep problems.
Bøe
M G
MG
Department of Neurology, Sørlandet Hospital, Kristiansand, Norway. magne.geir.boe@sshf.no
Salvesen
R
R
Mygland
A
A
D000328:Adult; D000700:Analgesics / Q000009:adverse effects*; D000701:Analgesics, Opioid / Q000009:adverse effects; D015984:Causality; D003061:Codeine / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D020773:Headache Disorders / Q000139:chemically induced* / Q000628:therapy*; D051271:Headache Disorders, Secondary / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D010147:Pain Measurement; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012647:Self-Assessment; D012893:Sleep Wake Disorders / Q000150:complications; D013375:Substance Withdrawal Syndrome; D013995:Time; D016896:Treatment Outcome
D000700:Analgesics; D000701:Analgesics, Opioid; D003061:Codeine