Detoxification of medication-overuse headache by a multidisciplinary treatment programme is highly effective: A comparison of two consecutive treatment methods in an open-label design
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Detoxification of medication-overuse headache by a multidisciplinary treatment programme is highly effective : A comparison of two consecutive treatment methods in an open-label design. / Munksgaard, Signe B; Bendtsen, Lars; Jensen, Rigmor H.
In: Cephalalgia, Vol. 32, No. 11, 2012, p. 834-44.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Detoxification of medication-overuse headache by a multidisciplinary treatment programme is highly effective
T2 - A comparison of two consecutive treatment methods in an open-label design
AU - Munksgaard, Signe B
AU - Bendtsen, Lars
AU - Jensen, Rigmor H
PY - 2012
Y1 - 2012
N2 - Background: Evidence for optimal medication-overuse headache treatment is lacking. Some experts suggest reduced symptomatic medication with prophylactics from the start of withdrawal, while others suggest a two-month drug-free period with multidisciplinary education. Aim: To examine the acceptability, feasibility and outcome of these two regimes in a non-randomised open-label study. Methods: Patients able to undergo outpatient detoxification, with medication-overuse headache that had previously been unsuccessfully treated by specialists and without significant co-morbidities were treated with (A) individual withdrawal with restricted symptomatic medication and prophylactics from Day 1 or (B) a two-month drug-free period and multidisciplinary education in groups. All patients received close one-year follow-up. Results: Eighty-six of 98 patients completed follow-up. Both treatments proved highly effective-80.0% of Group A and 85.4% of Group B were cured of medication-overuse headache. Headache-frequency reduction was 40.2% in Group A and 38.4% in group B. In 48.9% of group A and 48.8% of group B, headache-frequency reduction was >50%. Programme B required fewer resources from the staff and only 61.9% of these patients needed prophylactics after two months compared with 84.8% in programme A. Conclusions: Both structured detoxification programmes proved highly effective with one-year close follow-up in previously treatment-resistant patients with medication-overuse headache. We suggest multidisciplinary education for patients in groups and delaying initiation of prophylactics until after the detoxification.
AB - Background: Evidence for optimal medication-overuse headache treatment is lacking. Some experts suggest reduced symptomatic medication with prophylactics from the start of withdrawal, while others suggest a two-month drug-free period with multidisciplinary education. Aim: To examine the acceptability, feasibility and outcome of these two regimes in a non-randomised open-label study. Methods: Patients able to undergo outpatient detoxification, with medication-overuse headache that had previously been unsuccessfully treated by specialists and without significant co-morbidities were treated with (A) individual withdrawal with restricted symptomatic medication and prophylactics from Day 1 or (B) a two-month drug-free period and multidisciplinary education in groups. All patients received close one-year follow-up. Results: Eighty-six of 98 patients completed follow-up. Both treatments proved highly effective-80.0% of Group A and 85.4% of Group B were cured of medication-overuse headache. Headache-frequency reduction was 40.2% in Group A and 38.4% in group B. In 48.9% of group A and 48.8% of group B, headache-frequency reduction was >50%. Programme B required fewer resources from the staff and only 61.9% of these patients needed prophylactics after two months compared with 84.8% in programme A. Conclusions: Both structured detoxification programmes proved highly effective with one-year close follow-up in previously treatment-resistant patients with medication-overuse headache. We suggest multidisciplinary education for patients in groups and delaying initiation of prophylactics until after the detoxification.
U2 - 10.1177/0333102412451363
DO - 10.1177/0333102412451363
M3 - Journal article
VL - 32
SP - 834
EP - 844
JO - Cephalalgia
JF - Cephalalgia
SN - 0800-1952
IS - 11
ER -
ID: 48425446