Medication Overuse Headache (MOH)


Medication overuse headache is one of the biggest problems that headache and particularly migraine patients face. Every headache sufferer should become familiar with this type of headache. According to IHS, it is “the most common cause of migraine headache occurring on more than fifteen days per month, and of a mixed picture of migraine-type and TTH on more than fifteen days per month.”

MOH is defined as chronic daily headache due to excessive use of acute headache medications. Rebound or MOH is a perfect example of our society’s addiction to instant gratification. Patients want quick relief from their headache without seeking a cure for the cause of the pain. Since the cause is not addressed properly, the headache keeps recurring. The patient keeps taking medication to get quick relief, and as the pain-free period between headaches lessens, the patient becomes more dependent on the medication, leading to the vicious cycle where the cure becomes the cause of further pain and suffering. This is true for both OTC medications and stronger prescription medications. In fact, it has been shown that all drugs used for the acute treatment of headache can cause MOH.

Overuse is defined as using medications for more than 2 or 3 days per week on a regular basis for 3 or more months. Some drugs can cause MOH with even 10 days of use per month regularly, such as ergotamine, triptans or opioids, while other drugs require 15 or more days of use per month, such as simple analgesics or combination of acute drugs.

Patients suffering from MOH can be difficult to treat, and may require detoxification from the offending medication. This is one condition that can be effectively treated using a multi-pronged approach, using a combination of preventative medications, homeopathy, Ayurvedic medicine, yoga, dietary manipulation and other therapies in a personalized method tailored to each individual headache sufferer. A cookie-cutter, one technique-fits-all approach is not an ideal method for addressing this type of condition, and is most likely doomed for failure. In other words, the treatment has to be designed for each patient individually, based upon his or her unique circumstances.