Completely stopping medication is both more feasible and more effective than restricting medication intake for the treatment of medication-overuse headache (MOH), according to a new study. Engelstoft and co-workers randomly assigned patients with MOH to either 2 months of medication withdrawal without any analgesics or acute migraine medications (complete withdrawal group) or to continuation of usual analgesics and/or migraine medication up to 2 days per week during the withdrawal period (restricted intake group). Patient-graded feasibility of withdrawal was significantly higher in the complete withdrawal group than in the restricted intake group. At 12 months, psychological dependence on headache medication showed greater reductions in the complete withdrawal group than in the restricted intake group; headache-related anxiety was also reduced to a greater extent in the complete withdrawal group.
Engelstoft, I. M. et al. Complete withdrawal is the most feasible treatment for medication-overuse headache: a randomized controlled open-label trial. Eur. J. Pain https://doi.org/10.1002/ejp.1383 (2019)
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Kelsey, R. Complete withdrawal more feasible and effective than restriction in medication-overuse headache. Nat Rev Neurol 15, 188 (2019). https://doi.org/10.1038/s41582-019-0162-8