Reduction in medication-overuse headache after short information. The Akershus study of chronic headache

Eur J Neurol. 2011 Jan;18(1):129-37. doi: 10.1111/j.1468-1331.2010.03094.x.


Objective: our aim was to investigate the course of medication-overuse headache in the general population and the effect of simple advice regarding medication overuse.

Design: prospective cohort study. Participants were identified in a cross-sectional epidemiological sample of 30000 persons aged 30-44 from the general Norwegian population. People with chronic headache (≥ 15 days per month for at least 3 months) and medication overuse received short information about the possible role of medication overuse in headache chronification. A cohort was followed up 1½ years later. The diagnostic criteria of the International Classification of Headache Disorders and data splitting methodology were used.

Setting: Akershus University Hospital, Oslo, Norway.

Participants: a total of 109 participants with chronic primary headache and medication overuse were available for follow-up (85% participation rate).

Main outcome measure: Change in medication days and headache days per month.

Results: at baseline chronic tension-type headache was found in 92% of participants; 8% had chronic migraine or new daily persistent headache. Migraine co-occurrence was found in 53%. The mean duration of chronic headaches were 8-18 years, the mean duration of medication overuse between 5 and 10 years prior to intervention. At follow up, the mean medication days were significantly reduced from 22 days to 6 days per month, and 76% no longer had medication overuse. Forty-two percent no longer had chronic headache and the headache index was reduced by 24%.

Conclusion: our examination and short information served as a modified brief intervention which can improve chronic headache and medication overuse in the general population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease / epidemiology
  • Chronic Disease / therapy
  • Cross-Sectional Studies
  • Female
  • Headache Disorders, Secondary / diagnosis
  • Headache Disorders, Secondary / epidemiology
  • Headache Disorders, Secondary / therapy*
  • Humans
  • Male
  • Norway / epidemiology
  • Patient Education as Topic*
  • Prospective Studies
  • Surveys and Questionnaires
  • Tension-Type Headache / diagnosis
  • Tension-Type Headache / epidemiology
  • Tension-Type Headache / therapy*