Breaking the cycle of medication overuse headache

  • Cleveland Clinic Journal of Medicine
  • April 2010,
  • 77
  • (4)
  • 236-242;
  • DOI: https://doi.org/10.3949/ccjm.77a.09147

ABSTRACT

When patients who have frequent, disabling migraines take medications to relieve their symptoms, they run the risk that the attacks will increase in frequency to daily or near-daily as a rebound effect comes into play. This pattern, called medication overuse headache, is more likely to happen with butalbital and opioids than with migraine-specific drugs, as partial responses lead to recurrence, repeat dosing, and, eventually, overuse. Breaking the cycle involves weaning the patient from the overused medications, setting up a preventive regimen, and setting strict limits on the use of medications to relieve acute symptoms.

Footnotes

  • ↵* The authors have disclosed that they have received institutional research support from ATI, GlaxoSmithKline, MAP, and Merck and honoraria and consulting fees for teaching, speaking, consulting, and serving on advisory committees or review panels from GlaxoSmithKline, MAP, Merck, NuPathe, and Zogenix.

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