Early Treatment May Promote Medication-Overuse Headache

By MacNeil, Jane Salodof | Clinical Psychiatry News, February 2007 | Go to article overview

Early Treatment May Promote Medication-Overuse Headache


MacNeil, Jane Salodof, Clinical Psychiatry News


SCOTTSDALE, ARIZ. -- Early treatment of migraine can contribute to development of medication-overuse headaches in pain-adverse patients, Dr. James R. Couch warned at a symposium sponsored by the American Headache Society.

These patients will take their pills every time they think they might be about to get a migraine, said Dr. Couch, a professor of neurology at the University of Oklahoma Health Sciences Center in Oklahoma City.

"The more they think they are getting a headache and take the medication early, the more likely that this may lead to developing an MOH [medication-overuse headache]-induced chronic daily headache," he said.

The conundrum for prescribing physicians, as presented by Dr. Couch, is that current and previous studies show patients really do have a better response if they take their medications at the first sign of a migraine. He recommended early treatment for the patient who has an occasional menstrual-induced migraine, but suggested a cautious approach for those with more frequent headaches.

"If a patient is having 10 or more headaches a month, do not get them into the early treatment or be careful about the early treatment," he said. Instead, make sure these patients know when they are starting a headache as opposed to thinking they might be getting one.

"I think this is one of the main problems," Dr. Couch said.

He added that patients who "get a buzz" from their medication also could be at greater risk of developing MOH. Some patients will use their headache medication like a dose of alcohol, he warned. …

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