{"id":326050,"date":"2022-04-13T09:32:38","date_gmt":"2022-04-13T07:32:38","guid":{"rendered":"https:\/\/medizinonline.com\/s1-guideline-headache-associated-with-overuse-of-analgesics-or-migraine-medications\/"},"modified":"2023-01-11T09:08:16","modified_gmt":"2023-01-11T08:08:16","slug":"s1-guideline-headache-associated-with-overuse-of-analgesics-or-migraine-medications","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/en\/s1-guideline-headache-associated-with-overuse-of-analgesics-or-migraine-medications\/","title":{"rendered":"S1 Guideline Headache associated with overuse of analgesics or migraine medications"},"content":{"rendered":"

Under the direction of Hans-Christoph Diener, Department of Neuroepidemiology, Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University of Duisburg-Essen, and Prof. Dr. Peter Kropp, Director of the Institute of Medical Psychology and Medical Sociology, University Medical Center Rostock, Germany, the S1 Guideline on Medication Overuse Headache (MOH) was developed. updated and published. The worldwide prevalence of MOH ranges from 0.7% to 1%, and its treatment results in societal costs that are three times higher than those of episodic migraine.<\/strong><\/p>\n

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Several new findings necessitated the revision of the 2018 guidelines: The International Headache Society (IHS) classification of headache had further specified Medication Overuse Headache (MOH). In addition, monoclonal antibodies against CGRP or the CGRP receptor, such as topiramate and onabotulinumtoxinA, were shown to be effective not only in the prophylaxis of chronic migraine but also in headache caused by overuse of analgesics or migraine medications. However, the guideline authors emphasize that nonpharmacologic measures must complement pharmacologic prophylaxis in MOH. The greatest risk of relapse, he said, is in the first year after a medication break or withdrawal.<\/span><\/p>\n

MOH is said to occur when headaches occur on more than 15 days per month and are treated with one or more pain medications for a period of more than three months. For triptans, use on more than 10 days per month is required for diagnosis.<\/span><\/p>\n

The most important risk factors for MOH, the guideline states, are preexisting primary headache, such as migraine or tension-type headache, female gender, >10 headache days per month, low social status, other chronic pain disorders, stress, physical inactivity, obesity, smoking, dependent behaviors, and psychiatric disorders such as depression or anxiety disorder.<\/span><\/p>\n

Furthermore, the guideline provides an update on therapy, which should be performed in several stages. The success rate of such a staged therapy is about 50-70% after 6 to 12 months. There is a high rate of relapse, especially among patients with opioid overuse, he said. The levels include:<\/span><\/p>\n