More often than not, the first reaction to a pounding headache or migraine is to reach for relief. But if a medication doesn’t seem to be working, patients may increase the dose or take it more frequently. Some start to experience what’s know as “medication overuse headaches” (MOH), caused by an increased reliance on medications meant to relieve pain. The result is a chronic headache that becomes resistant to treatment.
An estimated 60 million people worldwide suffer from MOH, and it occurs with all types of headaches, ranging from migraines, cluster headaches or tension-type headaches.
What’s the treatment?
Withdrawal therapy is currently recommended as the only treatment for this disorder. But in a new study, published in the Journal of American Medical Association (JAMA) Neurology, researchers found that withdrawal therapy combined with the use of preventive medications was the most effective way of treating MOH.
The researchers compared three types of treatment in a group of 120 individuals with MOH, who were randomly assigned to one of the three treatment groups:
- Withdrawal plus preventive treatment
- Preventive treatment without withdrawal
- Withdrawal with optional preventive treatment two months after withdrawal
The researchers hypothesized the two strategies that included withdrawal would have similar results as far as a reduction in the number of headache days per month, and that there would be no need to begin preventive treatments early.
All three treatment approaches were effective in reducing MOH, but to the surprise of the researchers, the most effective was withdrawal therapy combined with preventive medication at the same time withdrawal had begun. Patients in this group experienced the largest reductions in headache days, migraine days, days with short-term medication use and headache pain intensity.
Thus, the researchers conclude, withdrawal therapy combined with preventive medication therapy from the start of withdrawal “is recommended as the preferred management of MOH.”