European Academy of Neurology guideline on the management of medication-overuse headache

Research output: Contribution to journalJournal articleResearchpeer-review

  • H. C. Diener
  • F. Antonaci
  • M. Braschinsky
  • S. Evers
  • Jensen, Rigmor Højland
  • M. Lainez
  • E. S. Kristoffersen
  • C. Tassorelli
  • K. Ryliskiene
  • J. A. Petersen

Background: The frequent use of medication to treat migraine attacks can lead to an increase in migraine frequency and is called medication-overuse headache (MOH). Methods: Based on the available literature in this guideline, the first step in patient management is education and counselling. Results: Patients with MOH should be managed by a multidisciplinary team of neurologists or pain specialists and behavioral psychologists. Patients in whom education is not effective should be withdrawn from overused drugs and should receive preventive treatment with drugs of proven efficacy. Patients with MOH in whom preventive treatment is not effective should undergo drug withdrawal. Drug intake can be abruptly terminated or restricted in patients overusing simple analgesics, ergots or triptan medication. In patients with long-lasting abuse of opioids, barbiturates or tranquilizers, slow tapering of these drugs is recommended. Withdrawal can be performed on an outpatient basis or in a daycare or inpatient setting.

Original languageEnglish
JournalEuropean Journal of Neurology
Volume27
Issue number7
Pages (from-to)1102-1116
Number of pages15
ISSN1351-5101
DOIs
Publication statusPublished - 2020

Bibliographical note

Publisher Copyright:
© 2020 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology

    Research areas

  • chronic migraine, medication, medication overuse, medication-overuse headache, migraine, prevention, primary headache, tension-type headache, therapy, treatment

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