I.V. Regimen Beneficial for Medication Overuse Headache
Page Tools
In a study conducted in eight hospital headache centers in Italy, a protocol for the treatment of medication overuse headache—abrupt discontinuation of the overused medication, accompanied by i.v. fluid replacement, dexamethasone, metoclopramide, and benzodiazepines for 7 to 15 days—was found to be generally effective, safe, and well-tolerated.
The 70 patients in the study had medication overuse headache attributed to combination analgesics in 26 cases (37.1%), simple analgesics in 18 cases (25.7%), triptans in combination with analgesics in 13 cases (18.6%), triptans alone in 9 cases (12.9%), and ergot derivatives (in combination) in 4 cases (5.7%). Half of the patients took more than one preparation; slightly more than one third took caffeine-containing preparations.
Mean Headache Index scores (days with headache divided by days observed) decreased significantly with treatment, from 0.92 at admission to 0.19 at discharge. Mean Daily Drug Intake scores (number of tablets or suppositories consumed every day) also decreased significantly, from 2.72 at admission to 0.22 at discharge. Although 28 patients were lost to follow-up by 6 months, the results appeared to remain stable over time among the 42 other patients.
Headache. 2010 Mar 5.