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This Article Figures Only Full Text Full Text (PDF) CME: Take the course for this article: Volume 66, Number 12, June 27, 2006 All Versions of this Article: 01.wnl.0000217914.30994.bdv1 66/12/1894    most recent Correspondence: Submit a response Correspondence: View responses Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zeeberg, P. Articles by Jensen, R. Search for Related Content PubMed PubMed Citation Articles by Zeeberg, P. Articles by Jensen, R. Related Collections All Headache All Clinical trials Clinical trials Observational study (Cohort, Case control)

Probable medication-overuse headache

The effect of a 2-month drug-free period

From the Danish Headache Center, Department of Neurology, University of Copenhagen, Glostrup Hospital, Denmark.

Address correspondence and reprint requests to Dr. P. Zeeberg, Danish Headache Center, Department of Neurology, University of Copenhagen, Glostrup Hospital, Nordre Ringvej 57, DK-2600 Glostrup, Denmark; e-mail: peter.zeeberg{at}dadlnet.dk

Objective: To describe the emerging profile of headache frequency following a 2-month drug-free period in patients with medication overuse.

Methods: All patients treated and discharged from Danish Headache Center in 2002 and 2003 had prospectively filled out a diagnostic headache diary on a daily basis. For patients with probable medication-overuse headache (MOH), the authors determined headache frequencies before and after medication withdrawal from these prospective recordings.

Results: Among 1,326 patients, 337 had probable MOH. Two hundred sixteen patients who stayed medication-free for 2 months were eligible. Overall, 45% of the patients improved, 48% had no change, and 7% had more headaches. Median age was 48 years, and male/female ratio 1:2.7. The relative reduction in headache frequency varied considerably with a 67% median reduction in migraine, 0% in tension-type headache (TTH), and 37% in patients with both migraine and TTH (MT). Comparing the diagnostic groups, the relative reduction in frequency differed between migraine and TTH (p < 0.001) and between MT and TTH (p < 0.01). Triptan/ergot overusers improved the most (p < 0.0001). The difference between MT and TTH remained significant when triptan/ergot overuse was controlled (p < 0.05).

Conclusion: These data demonstrate the benefit of withdrawal in already established medication overuse and support the existence of medication-overuse headache as a clinical entity.

This article was previously published in electronic format as an Expedited E-Pub on May 17, 2006, at www.neurology.org.

Supported by grants from "IMK Almene Fond." The funding source was not involved in any stage of the study.

Disclosure: The authors report no conflicts of interest.

Received August 16, 2005. Accepted in final form February 21, 2006.

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