Premium
Medication‐overuse headache detoxification reduces headache disability – the Akershus study of chronic headache
Author(s) -
Kristoffersen E. S.,
Grande R. B.,
Aaseth K.,
Russell M. B.,
Lundqvist C.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13674
Subject(s) - medicine , detoxification (alternative medicine) , population , migraine , physical therapy , confidence interval , odds ratio , cohort , chronic migraine , alternative medicine , environmental health , pathology
Background and purpose Medication‐overuse headache ( MOH ) is a chronic headache (≥15 days/month) associated with overuse of acute headache medication. The objective was to investigate headache‐related disability before and after self‐detoxification from MOH in the general population, as well as possible predictors for successful outcome. Methods This was a prospective cohort study. Participants were identified in a cross‐sectional epidemiological sample of 30 000 persons aged 30–44 from the general Norwegian population. People with MOH received short information about the possible role of medication overuse in headache chronification. A total of 108 of the 128 participants (84%) were eligible for follow‐up 1.5 years later. Results Using the Migraine Disability Assessment ( MIDAS ), people with MOH in the general population were heavily disabled (mean MIDAS score 42.1, 95% confidence interval 31.7–52.6) with a majority in the severe disability class. The MIDAS score was significantly reduced at follow‐up ( P < 0.001) for those with successful self‐detoxification. In multivariate analyses, co‐occurrence of migraine ( P = 0.044) and lower headache frequency at baseline ( P = 0.001) increased the odds for successful self‐detoxification and reversion to episodic headache. Conclusion Medication‐overuse headache causes substantial disability in the general population. Self‐detoxification leads to reduced headache frequency and disability, although 24% of the participants did not complete self‐detoxification. Detoxification should be offered to MOH patients as early as possible with a focus on headache frequency, disability and psychological distress.