Medication overuse headache

Abstract

Purpose of review: The current literature on medication overuse headache will be reviewed with regard to clinical presentation, pathophysiology, therapy and prognosis in the light of the new headache classification.

Recent findings: Medication overuse headache is a widely unrecognized medical condition, which according to recent epidemiological studies has evolved to the third most frequent form of headache after tension-type headache and migraine. The first classification of headache disorders from 1988 defined medication overuse headache (formerly called 'drug-induced headache') on the bases of drugs that were available in the 1980s. For the most important anti-headache drugs, including triptans, new data on specific clinical features and more important mean critical monthly dosages and mean critical monthly intake frequencies are now available. Furthermore, recent prospectively conducted studies have revealed rates and predictors of relapse after successful withdrawal.

Summary: The newly available data on medication overuse headache may provide the basis for future consensus guidelines for the management of this condition.