Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Complete withdrawal is the most feasible treatment for medication-overuse headache: A randomized controlled open-label trial

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Dependence-like behaviour in patients treated for medication overuse headache: A prospective open-label randomized controlled trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Von Frey testing revisited - provision of an online algorithm for improved accuracy of 50% thresholds

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Medication-overuse headache: The effect of a patient educational programme-A randomized controlled trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Genetic Susceptibility Loci in Genomewide Association Study of Cluster Headache

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Prevalence of pre-cluster symptoms in episodic cluster headache: Is it possible to predict an upcoming bout?

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Reference programme: diagnosis and treatment of headache disorders and facial pain. Danish Headache Society, 3rd edition, 2020

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Dependence-like behaviour in patients treated for medication overuse headache: A prospective open-label randomized controlled trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Neurovascular contact plays no role in trigeminal neuralgia secondary to multiple sclerosis

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Complete stop of acute medication and/or migraine medication for treatment of medication-overuse headache (MOH) has previously been reported more effective in reducing headache days and migraine days per month compared with restricted intake of acute medication. However, it is unknown whether complete stop or restricted intake is the most feasible treatment for patients.

OBJECTIVES: To investigate whether feasibility of withdrawal in MOH is different between complete stop of acute medication and restricted intake, and whether reductions in headache-related medication dependence, anxiety and depression differ between the treatments.

METHODS: Medication-overuse headache patients were included in a prospective, open-label, outpatient study and randomized to two months of withdrawal with either no analgesics or acute migraine medication (programme A) or acute medication restricted to 2 days/week (programme B). After 6 and 12 months, patients graded feasibility of withdrawal. Dependence was measured by Severity of Dependence Scale (SDS), while anxiety and depression were measured by Hospital Anxiety and Depression Scale (HADS).

RESULTS: We included 72 MOH patients with primary migraine and/or tension-type headache. Forty-nine completed withdrawal and the SDS questionnaire at 12-month follow-up, and the feasibility of withdrawal was significantly higher in programme A compared to programme B (p < 0.001). At 12 months, the dependence was reduced by 44% in programme A compared to 26% in programme B (p = 0.053), while the anxiety score was reduced by 32% and 11%, respectively (p = 0.048).

CONCLUSIONS: Withdrawal with complete stop of acute medication was more feasible and most effective in reducing headache-related anxiety compared with restricted intake.

SIGNIFICANCE: A complete stop of all analgesics is the most effective treatment for MOH regarding reduction in headache days but has often been regarded as too challenging for patients. However, in this study, complete stop appears to be more feasible compared with restricted intake of analgesics seen from the patients' perspective.

Original languageEnglish
JournalEuropean journal of pain
Volume23
Issue number6
Pages (from-to)1162-1170
Number of pages9
ISSN1090-3801
DOIs
Publication statusPublished - 2019

Bibliographical note

© 2019 European Pain Federation - EFIC®.

ID: 56715227