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Controversy over the Classification of Medication-Overuse Headache

Current Pain and Headache Reports volume 16, pages 80–85 (2012)Cite this article

Abstract

Medication-overuse headache (MOH) is a relatively common and impactful disorder, affecting 1% to 2% of the population, characterized by daily or near-daily headache aggravated by chronic acute medication intake. Primary headache patients do not necessarily develop MOH after acute medication overuse, although a pre-existing primary headache is inevitably present. Likewise, headache patients may deteriorate in terms of frequency without medication overuse, or suffer from chronic headache in the presence of drug abuse without any causal relationship. To classify and define diagnostic criteria for MOH in the absence of objective biomarkers is a difficult task that is presently based on clinical grounds and is limited in part by the relative lack of research in this field. The present criteria are less restrictive but also less precise than the previous versions because they allow the diagnosis without the previously required MOH confirmation after medication withdrawal. MOH should remain as a distinct secondary disorder based on the available clinical and pathophysiological evidence.

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Disclosures

Dr. Maurice Vincent has served as a board member for Allergan, receiving travel expense compensation from the company for attending meetings.

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Affiliations

  1. Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Avenida das Américas 1155, Room 504, CEP 22631-000, Rio de Janeiro, Brazil

    Maurice B. Vincent

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  1. Maurice B. Vincent
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Correspondence to Maurice B. Vincent.

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Vincent, M.B. Controversy over the Classification of Medication-Overuse Headache. Curr Pain Headache Rep 16, 80–85 (2012). https://doi.org/10.1007/s11916-011-0229-8

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  • DOI: https://doi.org/10.1007/s11916-011-0229-8

Keywords

  • Medication-overuse headache
  • Chronic daily headache
  • Classification
  • Triptans
  • Analgesics
  • Chronic headache
  • Chronic migraine
  • Classification
  • International Classification of Headache Disorders
  • Chronification