Treatment of drug overuse headache (MOH)

What is medication overuse headache

MOH is a worsening of your usual headache caused by taking medication for headaches or for other pain too often over a period of at least 3 months. All types of seizure medications for pain can induce MOH, even if taken for a type of pain other than headache. It is a condition that occurs in a large proportion of people who have frequent headaches - there is therefore also a lot of experience that the condition can be improved with the right treatment.

There is a risk of developing MOH if you have been taking the following painkillers for 3 months:

• Migraine medications for more than 9 days a month (triptans)
• Over-the-counter medicines for more than 14 days a month (Pamol, Ipren and others)
• Morphine/mixture preparations for more than 9 days a month (Dolol, Treo, Kodimagnyl and others)
• A mixture of the above types of medication more than 9 days a month in total

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What are the symptoms of medication overuse headache

You will get more frequent and stronger headaches. The medicine works worse. If you suffer from several types of headaches, they may be more difficult to distinguish from each other.

You may have headaches, nausea, feel unwell and heavy in the head when you wake up in the morning. It subsides after you take the first pills. You may also feel that you can overcome or exceed less than before, and that your quality of life has deteriorated.

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What is the treatment for medication overuse headache

The treatment of MOH is medication instillation, i.e. no painkillers for two months, neither for headaches nor for other pain conditions. The purpose of this break is to make your headache amenable to treatment again, by breaking the vicious circle of increasing headaches and growing medication consumption. Many people experience better overall well-being after some time.

If you are given medication for asthma, heart disease or any other illness, you should of course continue to take it. The doctor or nurse will talk to you about which medication you should continue with and which medication you should stop taking for the two months.

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What can you expect

The first few weeks, you may find that the headache gets worse. You may also have flu symptoms or sleep problems. When stopping morphine-like medications, you may experience diarrhea, fever, palpitations, sweating, as well as body and leg restlessness.

In some, the headache continues unchanged and in quite a few the headache will worsen. Most often, however, the genes subside over a few weeks and the headache subsides in frequency and strength. In addition, some people feel healthier when they do not take medication regularly.

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It may be a good idea to prepare for the medication cleanup:

• Decide on a date when you stop taking headache medication. Remove the medicine from your home.
• Tell family and friends that you are going through a period without medication and what they can/can not expect from you, - maybe they can support you too
• Limit obligations and agreements in the period
• Consider a sick leave/partial sick note - talk to your employer about it if necessary

Pain relief without medication

• Try to do what, by the way, usually helps (not medicine) when you have a headache
• Provide calm and rest and have time to nurse your headache
• Put something cold or warm on your head. It may relieve the pain.
• Ensure a healthy lifestyle; plenty of fluids, regular and healthy meals, plenty of sleep, fresh air, exercise and daily stretching exercises
• Think of something nice that can diffuse your thoughts and take them away from headaches — for example, go for a walk and look at the world around you

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