Medication Overuse Headache
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Medication overuse headache (MOH) is a common and disabling headache disorder. It has a prevalence of about 1–2 % in the general population. The International Classification of Headache Disorders 3rd edition (beta version) has defined MOH as a chronic headache disorder in which the headache occurs on 15 or more days per month due to regular overuse of medication. These headaches must have been present for more than 3 months. The pathophysiology is complex and not completely known. It involves genetic and behavioural factors. There is evidence that cortical spreading depression, trigeminovascular system and neurotransmitters contribute to the pain pathway of MOH. The treatment of MOH includes patient education, stopping the offending drug(s), rescue therapy for withdrawal symptoms and preventative therapy. Relapse rates for MOH are high at 41 %. MOH can severely impact quality of life, so it is important to identify patients who are at risk of analgesic overuse.
KeywordsMedication overuse headache Rebound headache Chronic daily headache Opioids Triptans Combination analgesics NSAIDS
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Conflict of Interest
Valerie Cheung and Farnaz Amoozegar declare that they have no conflict of interest.
Esma Dilli has received speaker honorarium from Allergen and Tribune (Cambia).
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This article does not contain any studies with human or animal subjects performed by any of the authors.
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