The course of treatment for drug overuse headaches is recommended on the Knowledge Card

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Drug overuse headache (MOH) is a chronic secondary headache caused by frequent or regular use of analgesics or acute antimigraine drugs for
primary headaches.

According to the classification of the International Headache Society (ICHD-3), MOH is defined as taking headache medications regularly for 10 or 15 days per month on the basis of primary headache≥s (analgesic drugs alone, taking ≥ 15 days / month; For triptan, ergotamine, opioids, and combination analgesics, take ≥10 days/month) for more than 3 months, and headaches
occur for 15 days or more per month.

Prophylactic treatment without discontinuation can reduce the frequency of headaches or migraines and the use of acute medications in the case of unintentional withdrawal (discontinuation) and is a reasonable approach
for patients with excessive use of analgesics or triptans.

Prophylactic treatment without discontinuation may be the treatment option
for patients with difficulty stopping the drug.

In patients who overuse opioids or analgesics containing barbiturates, and in patients with severe comorbidities (such as psychiatric disorders and epilepsy), the main treatment option is discontinuation (Figure 1
).

Figure 1 Recommended course of treatment for drug overuse headaches

Note: NSAID = NSAIDs; CGRP = calcitonin gene-related peptide
.