Patients were stratified by whether or not they overused acute headache medication during the 28-day baseline (with medication overuse defined as intake during baseline of simple analgesics on ≥15 days, or other medication types or combinations of types for ≥10 days, with intake on ≥2 days/week from the category of overuse).
Medication overuse was defined as simple analgesics intake on ≥15 days, or other medication types or combination of types intake for ≥10 days, with intake ≥2 days/week from the category of overuse.
P = 0.008 after Bonferroni correction) Groups: triptans (exclusively one, or more types of triptans), NSAIDs (exclusively one, or more types of NSAIDs), mixtures (consumption of drugs containing indometacin, caffeine and sedatives) BMI body mass index, DDI daily drug intake, MOH medication-overuse headache, LDQ Leed's drugs questionnaire, SBP systolic blood pressure, DBP dyastolic blood pressure.
These patients were not affected by medication overuse since the mean monthly tablet intake was 2.7 ± 3.0.
Additionally, the intake frequency and an overuse of attack-aborting medications (analgesics and triptans), use of prophylactic headache medication and non-pharmacological treatments according the recommendations of the German Headache and Migraine Society [29, 30] were further follow-up parameters.
The first of these two prospective trials was a randomized, double-blind, active-controlled crossover trial with treatment refractory medication overuse headache (MOH) with daily analgesic intake for at least 5 years and several failed detoxification attempts.
Finally, chronic pain patients are a population at risk for developping analgesic overuse; therefore, careful recording of drug intake is mandatory in these patients, especially in the ones with a history of migration, a history of headache and/or depression.
Psychological factors indeed seem to play a crucial role in predicting the outcome (e.g., reduction in headache attacks and medication intake or relapse into overuse) of detoxification and should be considered when treating these patients (2,3).
Withdrawal symptoms are usually relieved by further intake of the overused medication, but this could lead to perpetuation of the overuse.
Withdrawal symptoms are usually relieved by further intake of the overused medication, but this could also lead to perpetuation of the overuse.
