Medication overuse headache: strategies for prevention and treatment using a multidisciplinary approach

Medication overuse headache, which affects patients who have migraines and frequent headaches, is prevalent worldwide and can severely impact daily functioning. Medication overuse headache is often not recognised by primary care physicians or general practitioners, as patients may overuse medications that are freely available without a prescription. Overuse of codeine-containing analgesics is particularly problematic and contributes to ongoing morbidity and opioid-related mortality. This article aims to provide an overview of the detection, prevention, and management of medication overuse headache. The definition of medication overuse headache and the risk levels of commonly used symptomatic headache medications are presented. An algorithm consisting of a number of simple questions can assist general practitioners with identifying at-risk patients. Treatment strategies are discussed in the context of a multidisciplinary approach.