Treatment of chronic migraine with medication overuse: Is drug withdrawal crucial?

Chronic headaches have increasingly become a focus within the field of head pain. For the most part patients with frequent headaches eventually overuse their medications, and if it happens (the percentage is approximately 4%), the diagnosis of chronic migraine with medication overuse headache is clinically important, because patients rarely respond to preventive medications whilst overusing acute medications. Properly treating medication overuse with adequate strategies is an essential component for helping these patients to improve and for preventing relapses. The necessity of withdrawal performed by different treatment schedules, outcomes, and the long-term durability of treatment are discussed. © Springer-Verlag 2009