National Guideline Clearinghouse | Treatment of medication overuse headache – guideline of the EFNS headache panel.

full-text:
National Guideline Clearinghouse | Treatment of medication overuse headache – guideline of the EFNS headache panel.

Guideline Title

Treatment of medication overuse headache – guideline of the EFNS headache panel.

 

 

Bibliographic Source(s)

Evers S, Jensen R, European Federation of Neurological Societies. Treatment of medication overuse headache--guideline of the EFNS headache panel. Eur J Neurol 2011 Sep;18(9):1115-21. [57 references] PubMed

 

 

Guideline Status

This is the current release of the guideline.

Eur J Neurol. 2011 Sep;18(9):1115-21. doi: 10.1111/j.1468-1331.2011.03497.x.

Treatment of medication overuse headache--guideline of the EFNS headache panel.

Evers S, Jensen R; European Federation of Neurological Societies.

Source

Department of Neurology, University of Münster, Münster, Germany. everss@uni-muenster.de

Abstract

BACKGROUND:

  Medication overuse headache is a common condition with a population-based prevalence of more than 1-2%. Treatment is based on education, withdrawal treatment (detoxification), and prophylactic treatment. It also includes management of withdrawal headache.

AIMS:

  This guideline aims to give treatment recommendations for this headache.

MATERIALS AND METHODS:

  Evaluation of the scientific literature.

RESULTS:

  Abrupt withdrawal or tapering down of overused medication is recommended, the type of withdrawal therapy is probably not relevant for the outcome of the patient. However, inpatient withdrawal therapy is recommended for patients overusing opioids, benzodiazepine, or barbiturates. It is further recommended to start individualized prophylactic drug treatment at the first day of withdrawal therapy or even before. The only drug with moderate evidence for the prophylactic treatment in patients with chronic migraine and medication overuse is topiramate up to 200mg. Corticosteroids (at least 60mg prednisone or prednisolone) and amitriptyline (up to 50mg) are possibly effective in the treatment of withdrawal symptoms. Patients after withdrawal therapy should be followed up regularly to prevent relapse of medication overuse.

DISCUSSION AND CONCLUSION:

  Medication overuse headache can be treated according to evidence-based recommendations.
© 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

PMID:

21834901

[PubMed - indexed for MEDLINE]

Treatment of medication overuse headache--guide... [Eur J Neurol. 2011] - PubMed - NCBI