title: Breaking the cycle of medication overuse headache.
abstract: When patients who have frequent, disabling migraines take medications to relieve their symptoms, they run the risk that the attacks will increase in frequency to daily or near-daily as a rebound effect comes into play. This pattern, called medication overuse headache, is more likely to happen with butalbital and opioids than with migraine-specific drugs, as partial responses lead to recurrence, repeat dosing, and, eventually, overuse. Breaking the cycle involves weaning the patient from the overused medications, setting up a preventive regimen, and setting strict limits on the use of medications to relieve acute symptoms.
authors.affiliation: Center for Headache and Pain, Neurological Institute, T33, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. teppers@ccf.org
authors.forename: Stewart J
authors.initials: SJ
authors.lastname: Tepper
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Tepper
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D001463:Barbiturates / Q000008:administration & dosage / Q000009:adverse effects*; D004198:Disease Susceptibility; D051271:Headache Disorders, Secondary / Q000139:chemically induced* / Q000517:prevention & control*; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy*; D010353:Patient Education as Topic; D012008:Recurrence; D012307:Risk Factors; D013375:Substance Withdrawal Syndrome; D019966:Substance-Related Disorders / Q000517:prevention & control*; D009626:Terminology as Topic; D014363:Tryptamines / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000701:Analgesics, Opioid; D001463:Barbiturates; D014363:Tryptamines; C004470:butalbital