Medication-overuse headache

Members
Signe Bruun Munksgaard, Rigmor Jensen, Lars Bendtsen.

Background
Medication-overuse headache (MOH) is a daily or almost-daily type of headache that usually results from the chronification of primary forms, such as migraine or tension-type headache, as a consequence of the progressive increase in the intake of symptomatic drugs. MOH affects a percentage of 1.4-3% of the general population. Limited amount of data exists on the burden of MOH, even in developed Countries, but there is general agreement that the disease represents one of the most disabling disorders, which markedly deteriorates the quality of life of patients, exposing them to the risks of side-effects and co-morbid conditions.

Our knowledge on the mechanisms leading to MOH are limited, and there are virtually no data on how these severely patients are treated optimally. Thus, there is an urgent need for studies investigating the pathophysiology and treatment possibilities of MOH.

Current projects
A prospective study comparing two different treatment options for MOH (abrupt drug withdrawal and a 2 month drug free period compared with restricted intake of analgesics combined with prophylactic headache treatment).

A prospective study investigating pain modulation (peripheral and central pain sensitivity) before and after drug withdrawal.

An EU-founded multi-centre study (COMO-ESTAS) investigating the benefit of electronic headache diaries during detoxification of MOH.

Collaboration
C. Tassorelli, Fondazione Istituto Neurologico Casimiro Mondino, Italy. M. Lainez, Fundación de la Comunidad Valenciana para la Investigación Biomédica del Hospital Clínico Universitario De Valencia, Spain. Z. Katsarava, Universitaetsklinikum Essen, Germany. R. Fadic, Pontificia Universidad Catolica de Chile, Santiago, Chile. A. Stoppini, Fundacion para la Lucha contra las Enfermedades Neurologicas de la Infancia, Buenos Aires, Argentina. Lars Thorbjørn, Klinisk Biokemisk afdeling, Glostrup Hospital.