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dc.contributor.authorAlstadhaug, Karl Bjørnar
dc.contributor.authorOfte, Hilde Karen
dc.contributor.authorKristoffersen, Espen Saxhaug
dc.date.accessioned2018-04-03T11:53:58Z
dc.date.available2018-04-03T11:53:58Z
dc.date.issued2017-07-01
dc.description.abstractThe concept that headache treatment per se may be the cause of chronification of headache is not new,3 but our understanding of this concept, and the terminology defining it, have changed throughout the years. The criteria for MOH are based on expert consensus rather than formal evidence. According to the current definition in the latest (2013) International Classification of Headache Disorders–3 beta, MOH is essentially defined as headache on 15 days or more per month that is regarded as a consequence of regular overuse of headache medication in a patient with a pre-existing headache.18 The classification does not include the number of drug units or dosage used, but the number of days per month the drug is taken. Whether medication overuse is a separate secondary headache rather than a complication of a primary chronic headache (migraine or tension-type headache)14 is still debated. Medication overuse headache can occur in patients with an underlying secondary headache, but only exceptionally.11 All abortive headache medications taken regularly may lead to MOH.9,30 However, MOH must not be confused with immediate or delayed headache secondary to use of, exposure to, or withdrawal from other substances such as nitroglycerin, histamine, or caffeine.18 Reducing the dose and eventually discontinuing the overused medication are the natural first choices of treatment, but experts differ on the best way to do so. Among patients who manage to discontinue the overused medication, 50% to 70% will revert to an episodic headache pattern.9,11 In this Pain Clinical Update, we present MOH as a prevalent condition with huge individual and societal consequences, focus on the clinical aspects of this condition, and emphasize that it can be prevented and treated. This article is based on an unsystematic search in PubMed for criteria, guidelines, trials, and reviews of MOH followed by a discretionary selection of publications. Some of the references used as “clinical evidence sources” are commented on in the reference list.en_US
dc.descriptionSource at: <a href=http://doi.org/10.1097/PR9.0000000000000612> http://doi.org/10.1097/PR9.0000000000000612 </a>en_US
dc.identifier.citationAlstadhaug, K. B., Ofte, H. K. & Kristoffersen, E. S. (2017). Preventing and treating medication overuse headache. Pain Reports, 2(4), e612. http://doi.org/10.1097/PR9.0000000000000612en_US
dc.identifier.cristinIDFRIDAID 1551359
dc.identifier.doi10.1097/PR9.0000000000000612
dc.identifier.issn2471-2531
dc.identifier.urihttps://hdl.handle.net/10037/12463
dc.language.isoengen_US
dc.publisherLippincott, Williams & Wilkinsen_US
dc.relation.journalPain Reports
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrologi: 752en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrologi: 752en_US
dc.titlePreventing and treating medication overuse headacheen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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