Medication-overuse headache
ICD-10 G44.4 · ICD-11 8A84.Y

Treatment of Medication-Overuse Headache with Triptan or Simple Analgesic Overuse and No Major Psychiatric Comorbidity

This protocol addresses patients with medication-overuse headache driven by frequent use of triptans, simple (non-opioid) analgesics, or ergotamine — specifically those without major psychiatric comorbidity and without overuse of opioids, barbiturates, or tranquilizers.

Clinical Scenario

Overuse of triptans, simple (non-opioid) analgesics, or ergotamine. No major psychiatric comorbidity. No overuse of opioids, barbiturates, or tranquilizers.

Initial Treatment Approach

First-line management centres on a structured educational and counselling-based intervention — one that can be delivered across a range of clinical settings, from primary care to specialist practice. The complete evidence-based protocol is available below.

Treatment Goals

Transition from a chronic to an episodic headache pattern, and reduction of symptomatic medication intake to fewer than 10 days per month — assessed at 2 months.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/ene.14268

Advice alone is an appropriate initial treatment approach in patients who overuse triptans or simple analgesics and who do not have major psychiatric comorbidity.

Advice alone can be provided by trained headache nurses, general practitioners and neurologists in private practice.

Drug intake can be abruptly terminated or restricted in patients overusing simple analgesics, ergots or triptan medication.

Success was defined as transition from the chronic pattern of headache to an episodic one and reduction of the days of intake of symptomatic medications to <10 days/month.

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