Medication Overuse Headache: Inpatient vs Outpatient Treatment

Hans-Christoph Diener, MD, PhD

Hello. My name is Christoph Diener. I'm a neurologist from Essen University in Germany. Today's topic is chronic headache and medication overuse.

You all know that people who have frequent headaches tend to take too much acute medication, and they might develop a disorder called medication overuse headache. The International Headache Society has defined this entity as a condition in people who have a primary headache disorder like migraine or tension-type headache and who use analgesics on more than 15 days per month or triptans on more than 10 days per month.

There is a longstanding and ongoing debate about the best way to treat people with medication overuse headaches. I think no one would argue that these people have to be withdrawn from the overuse medication, but the discussion is whether this should be done on an inpatient or outpatient basis.

Today I will discuss a study[1] that was published in the journal Cephalalgia in August of this year [2011]. This study originates from France. The investigators recruited 82 patients with primary headache and medication overuse and randomly assigned them to receive withdrawal treatment as inpatients or withdrawal therapy as outpatients. About half of these patients had migraines. The remainder of patients had either chronic tension-type headaches or combination headaches.

http://www.medscape.com/viewarticle/750743