Medication overuse headache: Updating of the French recommendations regarding the treatment strategies - 10/09/21
working group
X. Moisset b, F. Radat c, C. Lucas d, ⁎pages | 5 |
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Highlights |
• | No significant difference in treatment outcome is found between inpatient versus outpatient treatment except in complicated MOH for which inpatient treatment is better. |
• | Patient education and counselling is essential in the management of MOH, and sometimes sufficient to improve medication intake. |
• | Support of a headache nurse during withdrawal treatment gives patients better chances of successful withdrawal. |
• | First-line prophylactic medication must be started from the beginning of detoxification. |
• | Presently, and awaiting more trials with anti-CGRP, topiramate is the first choice for prophylactic treatment in MOH migraineurs despite frequent adverse events. |
• | In France, onabotulinumtoxinA has just received (June 2021) approval for use in chronic migraine, with or without medication overuse. |
Abstract |
Regular and frequent use of analgesics and acute antimigraine drugs can increase the frequency of headache, and induce the transition from episodic to chronic migraine or medication-overuse headache (MOH). The one-year prevalence of this condition is between 1% and 2% in Europe, provoking substantial burden. MOH is more prevalent in people with comorbid depression, anxiety, and other chronic pain conditions. This paper aims at presenting an updating of French recommendations regarding treatments strategies. Prior French recommendations, published in 2014, were written in French. A literature search in the major medical databases including the terms “medication overuse headache”, “symptomatic medication overuse”, published between 2010 and 2020 was carried out. Three main strategies can be recommended and conducted in parallel: education and explanations about the negative consequences of overusing acute antimigraine drugs, discontinuation of the overused medication, and finally, preventive drug therapy and non-pharmacological prevention. Medication overuse headache remains a debated problem and evidence for the most effective treatment strategy is needed.
Le texte complet de cet article est disponible en PDF.Keywords : Medication overuse headache, Systematic review, Randomized controlled trials, Withdrawal, Treatment, Recommendation
Plan
Vol 177 - N° 7
P. 760-764 - septembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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