Medication Overuse Headache

Excerpt

According to the International Classification of Headache Disorders, 3rd edition (ICHD-3), a medication overuse headache is a secondary chronic headache disorder. This condition is defined as headaches occurring for 15 or more days per month for 3 or more months in patients who use acute headache treatments too frequently. Medication overuse headaches are believed to occur when medications intended to relieve headaches are consumed too frequently, leading to a secondary type of headache. This condition was previously called a rebound headache and is commonly observed in individuals with migraine; the excessive use of analgesics can transform episodic headaches into a chronic condition. The exact frequency of using the pain-relieving drug before developing the medication overuse headache varies and depends on the particular type of medication used. Causal agents include both simple and combination analgesics, triptans, ergot derivatives, and opioids, but potentially any painkiller can be the trigger. Patients who use simple analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) for 15 or more days, or who take combination analgesics—including ergots; barbiturates, such as butalbital; triptans; and opioids—for 10 or more days per month are considered to have a medication overuse headache. Medication overuse headaches are common in patients at risk of overusing acute medications. Individuals previously diagnosed with a primary headache disorder, particularly migraines or tension-type headaches, are at risk of developing this condition. Medication overuse headaches typically resolve once the overused medication is reduced or discontinued.