Medication Overuse Headache from Different Points of View

Dear Colleagues,

I invite you to submit your work for consideration in an upcoming Brain Sciences Special Issue on “Medication Overuse Headache from Different Points of View”. Original basic and clinical research, case reports, review articles, meta-analyses, and systematic reviews related to this entity are welcomed. It is our hope to enhance the continually evolving understanding of headache disorders by providing fresh insights into the aetiology and management of a broad range of syndromes, as illustrated by your contributions. Of greatest interest are novel biological discoveries and innovative applications of existing and newer drugs and devices. Thank you in advance for your efforts in unravelling the mysteries of what brings about headaches and their resolution.

MOH is a secondary headache disorder, although pathophysiologically and clinically, it represents a complication or transformation of most commonly occurring primary headaches. It is a complex entity with biological, psychological, and social aspects. Assessing the risk factors of MOH occurrence and treatment success is crucial for the primary and secondary prevention of this type of headache. A diagnosis of MOH is clinical, and its treatment is individualized, is highly dependent on an multidisciplinary team approach (neurologist, pain medicine specialist, behavioural psychologist, etc.), and should probably be attempted in primary care (leaving the more complicated cases to neurologists specialised in this type of complexity). For those who suffer from MOH and have poor information about MOH management, the choice of detoxication and prevention program should be made based on their clinical condition and evidence of intervention effectiveness. Discontinuation of excessive medication should be carried out abruptly for those who excessively use common analgesics, ergot preparations, and triptans. Gradual discontinuation, however, is advised for the excessive use of opioids, barbiturates, and sedatives. Also, this can be carried out in an outpatient basis, during a day-trip to the hospital, or in a hospital setting (the effectiveness is similar for all abovementioned conditions). However, determining the type of MOH is crucial in selecting the location and method for conducting a discontinuation of excessive medication use.

Medication overuse discontinuation, transitional therapy, preventive therapy, preventive relapse monitoring, and patient education and awareness are the foundations of a therapeutic approach.

In spite of all the abovementioned, MOH is a treatable and preventable public problem worldwide. The gain from treating patients with MOH is potentially high and may lead to substantial economic savings for society as well for individual patients.

Dr. Srdjan Ljubisavljević
Guest Editor

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• medication overuse headache
• MOH
• headache
• rebound headache
• painkiller headache
• migraine
• tension-type headache