Abstract
Results Treatment outcome was not different between patients treated with advice alone, outpatient, or inpatient treatment. Stratifying patients in groups with or without comorbidities revealed a difference in treatment outcome for patients with comorbidities in favor of inpatient treatment. Different prophylactic medication given during medication overuse showed a significant reduction in headache frequency for topiramate, gabapentin and pregabalin, but not for prednisolon compared with placebo. Delaying prophylactic medication to after detoxification reduced the number of patients who needed prophylactic medication. Predictors of treatment outcome were ambigous. Conclusion The type of treatment (inpatient, outpatient or advice alone) should be selected according to comorbidities of the patient. Delayed initiation of prophylactic medication probably causes less need of prophylactic medication and betters the effect of subsequent prophylactic medication. Topiramate, gabapentin and pregabalin are useful as prophylactics for MOH patients who are unable to undergo detoxification. No conflict of interest.
Highlights
Medication overuse headache (MOH) has an estimated prevalence of 0.7-1.7 % on a global scale
Topiramate, gabapentin and pregabalin are useful as prophylactics for MOH patients who are unable to undergo detoxification
Treatment outcome was not different between patients treated with advice alone, outpatient, or inpatient treatment
Summary
Medication overuse headache (MOH) has an estimated prevalence of 0.7-1.7 % on a global scale. From 4th European Headache and Migraine Trust International Congress: EHMTIC 2014 Copenhagen, Denmark. Background Medication overuse headache (MOH) has an estimated prevalence of 0.7-1.7 % on a global scale.
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