A New Study on the Simplified Approach to Detoxing Patients with Medication Overuse Headache

In a large European + Latin American study, they tried a simple approach of getting patients off rebounding medications (medications taken more than three days per week that causes the headaches to get worse over time).  Typically, the standard as been admission to a hospital and using IV DHE for several days while the pain medication (or overused triptan) is abruptly stopped.

We tend to use a much more cost effective approach of out patient management by staring a long term preventative medication as an outpatient, then using a short term preventative such as Methergine, and then tapering off the offending medication over a couple of weeks.  This way seems humane and effective and has one supporting study.

In this new approach done by the Europeans and Latin Americans, a simple preventative is started, then the offending pain medication is continued as usual for the first 7 days, then it is immediately stopped.  Starting on day eight a brand new abortive medication is introduced and a limit of no more than 2 days of use per week.  They had a relapse rate of only 10% whereas the approach of admitting to the hospital has a relapse rare of 40 %.