Treatment of withdrawal headache in patients with medication overuse headache: a pilot study

The Journal of Headache and Pain
Sabina CevoliPietro Cortelli

Abstract

Drug withdrawal still remains the key element in the treatment of Medication Overuse Headache (MOH), but there is no consensus about the withdrawal procedure. Still debated is the role of the steroid therapy. The aim of this study was to evaluate the effectiveness of methylprednisolone or paracetamol in the treatment of withdrawal headache in MOH. We performed a pilot, randomized, single-blinded, placebo controlled trial. MOH patients, unresponsive to a 3 months prophylaxis, underwent withdrawal therapy on an inpatient basis. Overused medications were abruptly stopped and methylprednisolone 500 mg i.v (A) or paracetamol 4 g i.v. (B) or placebo i.v. (C) were given daily for 5 days. Patients were monitored at 1 and 3 months. Eighty three consecutive MOH patients were enrolled. Fifty seven patients completed the study protocol. Nineteen patients were randomized to each group. Withdrawal headache on the 5th day was absent in 21.0% of group A, in 31.6% of group B and in 12.5% of group C without significant differences. Withdrawal headache intensity decreased significantly after withdrawal without differences among the groups. Rregardless of withdrawal treatment, 52% MOH patients reverted to an episodic migraine and 62% had no more m...Continue Reading

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Citations

Sep 8, 2017·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Matteo PaolucciFabrizio Vernieri
May 21, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·H C DienerJ A Petersen
Apr 2, 2020·Headache·Nicolas VandenbusscheZaza Katsarava
Aug 29, 2020·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Fabrizio VernieriClaudia Altamura
Jul 14, 2018·The Journal of Headache and Pain·Nicolas VandenbusscheZaza Katsarava
May 19, 2021·CNS Drugs·Christina Sun-EdelsteinAnan Srikiatkhachorn

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Methods Mentioned

BETA
prophylactic therapy

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