Medication overuse headache (MOH) is a chronic headache caused by overuse of analgesics or acute migraine medication, occurring mainly in patients with pre-existing primary headache, namely migraine and tension-type headache. More than 60 million people worldwide suffer from this highly disabling condition. However, MOH can be prevented and treated. Therefore, the aims of this thesis were to improve management of MOH in terms of prevention and optimized treatment options.

For prevention, we conducted a national awareness campaign in Denmark in collaboration with the Association of Danish Pharmacies and patient organizations. 

For optimizing treatment options, we conducted two randomized controlled trial (RCT). We compared 1) Withdrawal with complete stop of acute medication, and 2) Reduced intake of analgesics maximum two days a week. In the second RCT, three treatments were compared: 1) Withdrawal with preventive treatment from start, 2) Preventive treatment without withdrawal, and 3) Withdrawal with postponed, optional preventive treatment. The results of the treatment studies pointed out that a complete stop of analgesics combined with preventives from start was the most effective treatment strategy, now recommended in Danish guidelines. All findings are published in peer-reviewed journals.

Rigmor Højland Jensen

Lars Bendtsen

Signe Bruun Munksgaard

Maria Lurenda Westergaard