Document of revision and updating of medication overuse headache (MOH)

Abstract

Introduction: Medication overuse headache is a secondary headache in which the regular or frequent use of analgesics can increase the frequency of the episodes, causing the transition from episodic to chronic headache. The prevalence of medication overuse headache is approximately 1-2%, with higher rates among women aged 30-50 years and with comorbid psychiatric disorders such as depression or anxiety, or other chronic pain disorders. It is important to be familiar with the management of this disease. To this end, the Spanish Society of Neurology's Headache Study Group has prepared a consensus document addressing this disorder.

Development: These guidelines were prepared by a group of neurologists specialising in headache after a systematic literature review and provides consensus recommendations on the proper management and treatment of medication overuse headache. The treatment of medication overuse headache is often complex, and is based on 4 fundamental pillars: education and information about the condition, preventive treatment, discontinuation of the drug being overused, and treatment for withdrawal symptoms. Follow-up of patients at risk of recurrence is important.

Conclusions: We hope that this document will be useful in daily clinical practice and that it will update and improve understanding of medication overuse headache management.

Keywords: Cefalea con uso excesivo de medicación; Deshabituación; Detoxification; Ergot derivatives; Ergóticos; Medication overuse headache; Opioides; Opioids; Preventive treatment; Tratamiento preventivo; Triptanes; Triptans.