Multidisciplinary approach to patients with chronic migraine and medication overuse: experience at the Besta Headache Center

The question concerning treatment of chronic forms of migraine associated with medication overuse has been largely debated and discussed in the last years and clinical experience has indicated the withdrawal as the first step to treat these patients as the withdrawal is useful so that a preventive pharmacologic therapy can be effective. Moreover, in the last 15 years it has been realized that chronic migraine with medication overuse is clearly a biobehavioral disorder. This clinical condition is not only a painful condition residing in an abnormality of receptor physiology; it is more aptly recognized as a condition wherein emotion and pain are intermingled. For this reason a multidisciplinary strategy of treatment which considers every aspect of individual life, social and emotional, is needed.