Medication overuse headache (MOH), as the name implies, is a perpetuating cycle of having headaches and continuing to take acute medication on a frequent basis.

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Often when you experience a headache, you rely on as-needed treatment for immediate relief. If headaches are not well managed, you will continue to reach for acute medications. However, if taken greater than two or three days per week on a long-term basis, this can lead to the development of "rebound headaches," which is the colloquial term for Medication Overuse Headache.

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If you find yourself taking abortive treatment more days than not, it is likely you are experiencing MOH, and should seek care to discuss a more effective treatment plan.

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Patients with a history of migraine, tension-type headache, cluster headache, and hemicrania continua are more inclined to develop MOH, especially if headaches are not well-controlled, resulting in a need of more acute medications. Additionally, clinical research provides evidence that there is a genetic predisposition to MOH. We see that individuals with a prior history of headache disorders are more susceptible to experiencing this form of headache. Studies looking at individuals taking daily pain relievers for other chronic conditions, such as arthritis, are not likely to trigger rebound headaches in those without a headache disorder.

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Symptoms of Medication Overuse Headache

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Often a headache will occur upon awakening, relieved once the acute treatment is taken, and the headache begins to return once the medication wears off. These individuals will experience greater than 15 headache days per month. In addition, there is a regular overuse of acute treatment for more than three months with one or more medications.

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Causes of Medication Overuse Headache

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The risk of MOH appears to be highest with opioids, nonsteroidal anti-inflammatory drugs, butalbital-containing combination agents, and acetaminophen-aspirin-caffeine combination medications. In addition, ergotamines and triptans can contribute to MOH. Clinicians will emphasize the importance of limiting abortive treatment to no more than 2-3 days per week depending on the agent.

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Treatments for Medication Overuse Headache

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Treatment includes stopping the overused medication. Often bridge therapy will help to break this difficult cycle. In addition, your doctor will likely discuss a plan to add on preventive treatment. It is important to keep in mind that headaches may worsen during this time of withdrawing the current medication. There will be a plan in place to continue acute treatment with certain limits.

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Looking to speak with a neurologist about your headache or migraine? Consider trying Neura Health so you can schedule a video visit from the comfort of home. Our neurologists are available for same-day and next-day appointments so you can find relief fast.

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