title: Medication overuse headache.
abstract: BACKGROUND
  Medication overuse headache (MOH) affects between 1% and 2% of the general population but is present in up to 50% of patients seen in headache centers. There are currently no internationally accepted guidelines for treatment of MOH.
  
  
  METHODS
  A review of the current literature on MOH treatment and pathophysiology.
  
  
  RESULTS
  We conclude that headache frequency can be reduced to episodic headache in more than 50% of the patients by simple detoxification and information. Approximately half the patients will not have need for prophylactic medication after withdrawal. Pain perception is altered in patients with MOH but can be restored to a baseline pattern, indicating a reversible mechanism in the central sensitization leading to chronic pain. The great comorbidity with depression and anxiety could be a consequence of the altered serotonin metabolism indicating a reversible and potentially treatable condition.
  
  
  CONCLUSIONS
  Increased focus on MOH is extremely important, as MOH both can and should be treated and prevented. MOH is thus a diagnosis that should be considered in all chronic headache patients as the very first step in their management strategy. In the general population, prevention campaigns against MOH are essential to minimize chronic pain disability.
authors.affiliation: Danish Headache Centre, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.
authors.forename: Signe B
authors.initials: SB
authors.lastname: Munksgaard
authors.forename: Rigmor H
authors.initials: RH
authors.lastname: Jensen
mesh_terms: D000700:Analgesics / Q000009:adverse effects; D051271:Headache Disorders, Secondary / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology
chemical_list: D000700:Analgesics
keywords: medication overuse headache; pathophysiology of medication overuse headache; prophylactic medication; treatment of medication overuse headache