Complete detoxification is the most effective treatment of medication-overuse headache: A randomized controlled open-label trial:

BackgroundThere is lack of evidence on how to detoxify medication-overuse headache.AimTo compare the effect of complete stop of acute medication with restricted intake.MethodsMedication-overuse headache patients were included in a prospective, outpatient study and randomized to two months’ detoxification with either a) no analgesics or acute migraine-medication (program A), or b) acute medication restricted to two days/week (program B). Detoxification was followed by preventives if indicated. Patients were followed up at 2, 6 and 12 months. Percentage reduction in headache days/month after 6 months was the primary outcome.ResultsWe included 72 medication-overuse headache patients with a primary migraine and/or tension-type headache diagnosis. Fifty-nine completed detoxification, 58 (81%) were followed up at month 6 and 53 (74%) at month 12. At month 6, program A reduced headache days/month by 46% (95% CI 34–58) compared with 22% (95% CI 11–34) in program-B (p = 0.005), and 70% in program A versus 42% in p...