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Risk factors in medication overuse headache: A one-year follow-up study

Natascia Ghiotto, Grazia Sances, Federica Galli, Cristina Tassorelli, Elena Guaschino, Giorgio Sandrini and Giuseppe Nappi

in Headache care, research and education worldwide

Published on behalf of Oxford University Press

Published in print May 2010 | ISBN: 9780199584680
Published online November 2012 | e-ISBN: 9780191753435 | DOI: http://dx.doi.org/10.1093/med/9780199584680.003.010

Series: Frontiers in Headache Research Series

Risk factors in medication overuse headache: A one-year follow-up study

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Medication-Overuse Headache (MOH) represents a growing problem and a challenge for headache specialists. The study of prognostic factors in MOH patients is crucial for the study of etiological and pathophysiological mechanisms as well as for implementing the management of patients from the first step of drug withdrawal. In this regard, it is important to take into account the high rate of relapse of MOH after drug withdrawal, which ranges from 30% to 45%, mainly during the first year. This aspect needs focused attention to unveil the risk factors for relapse and to prevent/reduce its occurrence. From a different perspective, it is also noteworthy that a small, although relevant portion of patients overusing symptomatic drugs for headache do not respond to drug withdrawal. Who are they? Should we consider them as ‘false’ MOH? If not does it exist as a more complicated sub-form of MOH, which is also more difficult to treat? A study addressed to selected patients with low-medical needs and no psychiatric disorders showed a response rate of 85% by advice alone of drug withdrawal. Other studies not selecting patients with the initial diagnosis of probable MOH found 30% to 36% of non-responders to different detoxification programmes. The main aim of our study is the prospective monitoring for 12 months of a group of MOH patients who underwent drugs withdrawal, looking for factors related to the one-year prognosis.

Chapter.  1583 words. 

Subjects: Neurology ; Clinical Pharmacology and Therapeutics

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