Dr Rigmor Jensen Dispels Common Misconceptions About Medication Overuse Headache

Studies show giving preventive medication while taking away offending drugs is superior to continuing offending medication and adding preventive drugs in patients with medication overuse headache, said Rigmor Jensen, MD, professor of neurology at The University of Copenhagen and director of the Danish Headache Center.

Transcript:

The American Journal of Managed Care® (AJMC®): What are some common misconceptions about medication overuse headache?

Dr. Jensen: There's this misconception that it is just a purely treated migraine, and if the migraine is properly treated the medication overuse headache will disappear. Yes and no, there can be both sides of the coin, but there are studies that we have seen that in patients who don't withdraw the medication and only receive preventive, the outcome is not as good as if you both do preventive and take the offending drug away. So, the number 1 action in headache treatment is to take the drug away. Medication overuse is a significant trigger for chronification. But we see patients too late. We see them very late and they have had this overuse for years and they can be more dependent on this and have a psychological dependence. It is not a dependence disorder as such. But it could develop into that. From the beginning, it's not a dependence disorder, but it can develop into that. Patients are more depressed, more anxious, and they have to have that drug every day. So it's difficult.

What's really the key message here is that in every headache patient you see, inform them that there is a risk of overuse and overuse can make it worse. Treat them properly with a proper prevention and a proper limit. Limits are the number of days you're allowed to take medication. And if you hit that limit, we have to have a talk again and have a follow-up because something is wrong here. You have to be very careful that you don't take too much. That's really important because all the acute drugs can also have a negative effect on other things in your body, your stomach, you have gastrointestional symptoms. Recent studies show they also have an effect on your hormones, on your sex hormones. It is not an easy task. Information, education is key here.