Abstract

OBJECTIVE
To evaluate the long-term efficacy of a structured, multidisciplinary treatment program in patients who had been treated unsuccessfully for medication overuse headache by specialists in an open-label design.
BACKGROUND
Medication overuse headache is a common and disabling disease. Management is complicated by substantial treatment failure and relapse, and those who relapse and nonresponders to treatment are often excluded from studies on medication overuse headache.
METHODS
Patients with medication overuse headache who had previously been unsuccessfully treated by specialists and referred to a specialized, tertiary headache centre were recruited. They underwent a structured 2-month detoxification program and were subsequently closely followed up for 10 months by a multidisciplinary team of physicians, nurses, physiotherapists, and psychologists.
RESULTS
Eighty-six of 98 patients completed the study.
PRIMARY OUTCOME
At 12-month follow-up, headache frequency was reduced by 39.3% (P < .001), 71 patients (82.6%) remained cured of medication overuse, reduction in headache frequency of more than 50% occurred in 42 patients (48.8%), and 52 (60.5%) reverted to episodic headache. Both of these figures had increased significantly from month 2 to month 12 (P < .001). Medication use was reduced by 62.8% (P < .001).
CONCLUSION
Patients with medication overuse headache previously regarded treatment-resistant benefit considerably from multidisciplinary treatment in a structured detoxification program with close follow-up.

Links

Publisher Full Text

Authors

Munksgaard SB, Bendtsen L, Jensen RH

Institution

Danish Headache Centre, Department of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Nordre Ringvej 57, Glostrup, Denmark.

Source

Headache 52:7 pg 1120-9

MeSH

Adolescent
Adult
Aged
Analgesics
Delivery of Health Care, Integrated
Drug Resistance
Female
Follow-Up Studies
Headache Disorders, Secondary
Humans
Incidence
Male
Metabolic Detoxication, Drug
Middle Aged
Nurses
Physical Therapists
Physicians
Psychology
Treatment Outcome
Young Adult

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

22724425