Session 2 - Medication overuse headache

Louise Ninett Carlsen

MD, PhD student, Danish Headache Center, Rigshospitalet Glostrup, Denmark

Three strategies are effective in reducing headache days in patients with MOH. These were compared in a non-blinded randomized trial in 120 patients with MOH associated with migraine or tensiontype headache: withdrawal plus preventive therapy from the outset, preventive therapy alone with no advice on withdrawal, and withdrawal alone (with an option to start preventive therapy after two months).

References
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2. Silberstein SD, Blumenfeld AM, Cady RK, et al. Onabotulinum toxin A for treatment of chronic migraine: PREEMPT 24-week pooled subgroup analysis of patients who had acute headache medication overuse at baseline. J Neurol Sci. 2013;331:48-56.
3. Tepper SJ, Diener HC, Ashina M, et al. Erenumab in chronic migraine with medication overuse: Subgroup analysis of a randomized trial. Neurology. 2019;92):e2309-e2320.
4. Tassorelli C, Jensen R, Allena M, et al; the COMOESTAS Consortium. A consensus protocol for the management of medication-overuse headache: Evaluation in a multicentric, multinational study. Cephalalgia. 2014;34:645-655.
5. Pijpers JA, Kies DA, Louter MA, et al. Acute withdrawal and botulinum toxin A in chronic migraine with medication overuse: a double-blind randomized controlled trial. Brain. 2019;142:1203-1214.
6. Carlsen LN, Munksgaard SB, Nielsen M, et al. Comparison of 3 treatment strategies for medication overuse headache: a randomized clinical trial. JAMA Neurol. 2020;77:1069-1078.