Medication-induced headache: pathogenesis, diagnosis and treatment
Medication-induced headache (MIH) is one of the most common forms of chronic headache (HA), management of patients with MIH remains an urgent problem of the modern healthcare. MIH is defined as HA lasting for more than 15 days per month for over 3 months against a background of excessive use of drugs for relief of HA. Epidemiological data, current diagnostic criteria, risk factors, pathophysiology and treatment of MIH are described. Risks and causes of recurrence, and prognosis of the disease are described. The only effective strategy for the management of patients is withdrawal of the drug that caused MIH. For the purpose of managing MIH and its different symptoms, a variety of symptomatic drugs with the exception of the class of drugs that caused MIH may be prescribed. The focus is on Excedrin - a combination analgesic which proved effective in the acute phase of drug withdrawal. For most patients, detoxification and preventive therapy on an outpatient basis may be feasible. An important role belongs to educational programs devoted to the aspects of MIH formation and transformation of HA to chronic.