Medication Overuse Headache

Pathway Publish Date: October 2024

Pathway Next Review Date: October 2026

Medication overuse headache:

- Headache occurring on 15 or more days per month in a person with a pre-existing primary headache disorder, which develops as a consequence of regular overuse of one or more drugs that can be taken for acute and/or symptomatic treatment of headache, for more than 3 months. It usually, but not always, resolves after the overused medication is stopped.
- Ergotamines, triptans, opioids, or combination analgesics are taken on 10 days or more per month.
- Simple analgesics such as paracetamol, nonsteroidal anti-inflammatory drugs (NSAIDs), or aspirin (either alone or in any combination) are taken on 15 days or more per month.
Medication overuse headache is a chronic headache disorder, and the pre-existing primary headache is migraine in 60–80% of people, or more rarely tension-type headache.
- Medication overuse headache is generally of the same phenotype as the primary headache.
Complications may include stress, anxiety, depression, sleep disturbance, and an increased risk of transition from episodic to chronic migraine if untreated.
Most people with medication overuse headache improve after withdrawal of overused medication.

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