RAG rating
n/a
Document type
Decision document
Place
South and West Hertfordshire
Output type
Pharmacy / Prescribing
Clinical Pathways
Pathway
Medication Overuse Headache Pathway

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.


 
Please see pathway attached for further information 
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