European Academy of Neurology guideline on the management of medication-overuse headache

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • H. C. Diener
  • F. Antonaci
  • M. Braschinsky
  • S. Evers
  • Jensen, Rigmor Højland
  • M. Lainez
  • E. S. Kristoffersen
  • C. Tassorelli
  • K. Ryliskiene
  • J. A. Petersen

Background: The frequent use of medication to treat migraine attacks can lead to an increase in migraine frequency and is called medication-overuse headache (MOH). Methods: Based on the available literature in this guideline, the first step in patient management is education and counselling. Results: Patients with MOH should be managed by a multidisciplinary team of neurologists or pain specialists and behavioral psychologists. Patients in whom education is not effective should be withdrawn from overused drugs and should receive preventive treatment with drugs of proven efficacy. Patients with MOH in whom preventive treatment is not effective should undergo drug withdrawal. Drug intake can be abruptly terminated or restricted in patients overusing simple analgesics, ergots or triptan medication. In patients with long-lasting abuse of opioids, barbiturates or tranquilizers, slow tapering of these drugs is recommended. Withdrawal can be performed on an outpatient basis or in a daycare or inpatient setting.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Neurology
Vol/bind27
Udgave nummer7
Sider (fra-til)1102-1116
Antal sider15
ISSN1351-5101
DOI
StatusUdgivet - 2020

Bibliografisk note

Funding Information:
H.C.D. received honoraria for participation in clinical trials, contribution to advisory boards or oral presentations from Addex Pharma, Alder, Allergan, Almirall, Amgen, Autonomic Technology, AstraZeneca, Bayer Vital, Berlin Chemie, Böhringer Ingelheim, Bristol‐Myers Squibb, Chordate, Coherex, CoLucid, Electrocore, GlaxoSmithKline, Grünenthal, Janssen‐Cilag, Labrys Bioloogicals, Lilly, La Roche, 3M Medica, Medtronic, Menerini, Minster, MSD, Neuroscore, Novartis, Johnson & Johnson, Pierre Fabre, Pfizer, Schaper and Brümmer, Sanofi, St. Jude, Teva and Weber & Weber. Financial support for research projects was provided by Allergan, Almirall, AstraZeneca, Bayer, Electrocore, GSK, Janssen‐Cilag, MSD and Pfizer. Headache research at the Department of Neurology in Essen is supported by the German Research Council (DFG), German Ministry of Education and Research (BMBF) and European Union. H.C.D. has no ownership interest and does not own stocks of any pharmaceutical company. H.C.D. serves on the editorial boards of and . H.C.D. chairs the Clinical Guidelines Committee of the German Society of Neurology. F.A. serves on the editorial board of and received honoraria for oral presentations from Teva, Pfizer, Almiral and Astra Zeneca. S.E. received honoraria for participation in clinical trials, contribution to advisory boards or oral presentations from Addex Pharma, Allergan, Almirall, AstraZeneca, Bayer Vital, Berlin Chemie, Böhringer Ingelheim, CoLucid, Eisai, Electrocore, GlaxoSmithKline, Ipsen, Janssen‐Cilag, Lilly, Menarini, MSD, Mundipharma Novartis, Johnson & Johnson, Pierre Fabre, Pfizer, Teva and Weber & Weber. Financial support for research projects was provided by Allergan, Almirall, AstraZeneca, Bayer, Electrocore, GSK, Janssen‐Cilag, MSD and Pfizer. S.E. has no stocks of any pharmaceutical company. S.E. serves on the editorial boards of and . S.E. is Honorary Secretary of the International Headache Society and Chair of the Headache Panel of the European Academy of Neurology. K.R. received honoraria for contribution to advisory boards or oral presentations from Allergan, Berlin Chemie, Novartis and Pfizer. M.L. received honoraria for participation in clinical trials, contribution to advisory boards or oral presentations from Allergan, ATI, Bial, Chiesi, ElectroCore, Eli Lily, Medtronic, Novartis, Teva and UCB. Financial support for research projects was provided by Allergan, Amgen, Bayer, Boehringher, ElectroCore, Eli Lily, Novartis, Otsuka, Roche and Teva. M.L. has no stocks of any pharmaceutical company. M.L. serves on the editorial board of . M.L. is vice president of the Sociedad Española de Neurología and chairman of the Spanish group of the of the International Headache Society. E.S.K. has received unrestricted research grants from the University of Oslo, Akershus University Hospital and Novartis through the Norwegian Neurological Federation. E.S.K. has no ownership interest and does not own stocks of any pharmaceutical company. E.S.K. is vice‐president of the Norwegian Headache Society. R.J. has received honoraria, travel grants and an unrestricted research grant from Autonomic Technologies, Allergan and Novartis and conducted clinical trials for Eli Lilly, ElectroCore and ATI. R.J. is a director in LTB and a trustee in the International Headache Society. C.T. has received honoraria for lecturing or consulting and travel grants from Allergan, electroCore, Eli Lilly, Novartis and Teva. She has conducted clinical trials for Alder, Allergan, electroCore, Eli Lilly and Teva. She has received research grants from the European Commission and Italian Ministry of Health. C.T. has no ownership interest and does not own stocks of any pharmaceutical company. C.T. serves as Section Editor of and on the editorial board of . C.T. chairs the Committee for the Guidelines of Clinical Trials of the International Headache Society. K R.. declares no financial or other conflicts of interest. J.A.P. received honoraria for consultancy, contribution to advisory boards or oral presentations from Almirall, Gruenenthal, Lilly, Merz and Novartis. Headache and pain research at the Department of Neurology in Zurich is supported by ATI, Biogen and Novartis. M.B. received travelsupport from the European Headache Federation. Cephalalgia Lancet Neurology Journal of Headache and Pain Cephalalgia European Journal of Pain Neurologia Frontiers in Neurology Journal of Headache and Pain

Funding Information:
We thank the European Academy of Neurology guideline group for support with the GRADE tables.

Publisher Copyright:
© 2020 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology

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