title: Prevention and management of medication overuse headache.
abstract: OBJECTIVE
  This review provides an update on our knowledge regarding prevention and management of medication overuse headache (MOH).
  
  
  RESULTS
  The prevalence of MOH is 1-2% in the general population worldwide, and because of the tremendous socio-economic cost, it is likely to be the most costly neurological disorder known. MOH has similarities with traditional drug addiction. Use of a brochure on medication overuse can prevent MOH. The Severity of Dependence Scale (SDS) score is a significant predictor of medication overuse among headache patients. Withdrawal of medication is essential in the management of MOH, and simultaneous initiation of prophylactic medication may alleviate this process. Short advice on medication overuse by a physician reduced mean medication days from 22 to 6 days; 76% no longer had medication overuse and 42% no longer had chronic headache.
  
  
  CONCLUSIONS
  A brochure and/or the SDS should be used to prevent MOH. Withdrawal is the cornerstone of MOH management. Short advice on MOH is the current most cost effective management method, a method that can be applied anywhere including third world countries.
authors.affiliation: Head and Neck Research Group, Research Centre, Akershus University Hospital, 1478 Lørenskog, Norway. m.b.russell@medisin.uio.no
authors.forename: Michael Bjørn
authors.initials: MB
authors.lastname: Russell
authors.forename: Christofer
authors.initials: C
authors.lastname: Lundqvist
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D019468:Disease Management; D051271:Headache Disorders, Secondary / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology
chemical_list: D000700:Analgesics