Medication overuse headache

G44.4


DESCRIPTION

Medication overuse headache generally occurs for ≥15 days per month for more than 3 months; and develops as a consequence of regular overuse of analgesics for acute pain-relief. The headache develops or markedly worsens during medication overuse, and usually, but not invariably, resolves after the overuse is stopped.

LoE:III [48]

GENERAL MEASURES

Stop all analgesics.

Counsel patient regarding the link between overuse of analgesics and the development of and/or worsening of the headache syndrome.

The headache usually resolves after the overuse is stopped, but may transiently worsen.

MEDICINE TREATMENT

  • Amitriptyline, oral, 10 mg at night.
    • Increase to a maximum of 75 mg at night. LoEII [49]
    • May be used during withdrawal of acute or symptomatic headache treatment.