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Treatment of Medication Overuse Headache

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The Cleveland Clinic Manual of Headache Therapy

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Abstract

Medication overuse or rebound headache (MOH) is a secondary chronic daily headache (CDH), defined by a worsening and transformation of episodic migraine into daily or near-daily headache, associated with overuse of acute anti-migraine medications. The frequency at which acute medication results in MOH varies, and can be as little as 5 days of use per month for butalbital, 8 days per month for narcotics, and 10 days per month for triptans and NSAIDs.

Prevention of MOH is encouraged by using headache diaries to keep number of headache days per month low with optimal use of acute medications, and intervention with preventive medications when appropriate. Treatment of MOH is predicated on absolute wean of overused medications, establishing prophylaxis, providing migraine-specific acute medications with limits, and behavioral and educational interventions and therapies. Limiting acute medication use to 2 days per week is a prudent first step.

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Author information

Authors and Affiliations

  1. Center for Headache and Pain, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, USA

    Stewart J. Tepper M.D.

  2. Center for Headache and Pain, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

    Deborah E. Tepper M.D.

Authors
  1. Stewart J. Tepper M.D.
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  2. Deborah E. Tepper M.D.
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Correspondence to Stewart J. Tepper M.D. .

Editor information

Editors and Affiliations

  1. Cleveland Clinic Lerner College of Medicine Center for Headache and Pain, Neurological Institute Cleveland Clinic, Cleveland, OH, USA

    Stewart J. Tepper MD (Professor of Medicine (Neurology) (Professor of Medicine (Neurology)

  2. Center for Headache and Pain, Neurological Institute Cleveland Clinic, Cleveland, OH, USA

    Deborah E. Tepper MD

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© 2011 Springer Science+Business Media, LLC

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Tepper, S.J., Tepper, D.E. (2011). Treatment of Medication Overuse Headache. In: Tepper, S.J., Tepper, D.E. (eds) The Cleveland Clinic Manual of Headache Therapy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0179-7_11

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  • DOI: https://doi.org/10.1007/978-1-4614-0179-7_11

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-0178-0

  • Online ISBN: 978-1-4614-0179-7

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