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Drug induced HA

Diagnostic criteria by IHS

A: Headache present on ≥15 days/month fulfilling criteria C and D

B: Regular overuse for ≥3 months of one or more drugs that can be taken for acute and/or symptomatic treatment of headache

Übergebrauch ist definiert als Einnahme an >=10Tagen für Ergotamine, Triptane, Opioide, Schmerzmittelmischpräparate und die Kombination von Akutpräparaten sowie als Einnahme an >=15 Tagen für Analgetika.

C: Headache has developed or markedly worsened during medication overuse

D: Headache resolves or reverts to its previous pattern within 2 months after discontinuation of overused medication

  • Anamnesis (duration, used drugs, social anamnesis)

  • Examination (clinical report of the cranial nerves, cervical spine, teeth- condition, blood pressure)

  • Characterization of headache (throbbing, electrical, sharp)

  • Localisation (occipital, bilateral, unilateral, frontal)

  • Temporary appearance (how often?, how long lasting?)

  • Trigger (menstruation, wine, cheese, sleep, sport, sex)

  • Headache questionary by Essen

  • Calender for headache

  • Excluding of other diagnosis (blood pressure, MRT of the head, blood sample)

Overuse is defined as regular overuse for ≥3 months of one or more drugs that can be taken for acute and/or symptomatic treatment of headache.

It also applies for the use on more than 10 days per month for Ergotamine, Triptane, Opioids and for the use of analgesics on more than 15 days per month

The only way of treatment is to reduce the overuse. During the acute period it is possible to support with other drugs or non- drug therapies like acupuncture.