Talk:Medication overuse headache

Confusion
This article isn't 100% clear. There is a confusion between transformed migraine and MOH. Transformed migraine cannot be caused by medication overuse, because, if the cause is medication overuse, it's called medication overuse headache and NOT transformed migraine. Thus, the use of the phrasing "transforms" in the introduction is misleading.

Also, it cannot possibly happen that the headache doesn't get better after quitting the drug, like the article implies ("Two months after completion of withdrawal patients suffering from medication overuse headache typically notice a marked reduction in migraine and other headache frequency and intensity"). If the headache doesn't get better after quitting the drug, the diagnosis of MOH was WRONG. The correct diagnosis is likely to be transformed migraine or chronic tension-type headache.

Credibility
Rebound headaches, do they really exist, or are they all inside your head? :-) I've read contrary articles, peer reviewed, but do not remember the source. If you know of sources for both discussion points, please post.


 * I have daily morning headaches which two doctors have said may be caused by a rebound effect of the medication I use (Imitrex).  So they, at least, believe that certain medications used for headache can exhibit a rebound effect.  Whether there are rebound headaches, per se, which are different from other kinds of headaches, I don't know. –Shoaler (talk) 16:40, 17 August 2005 (UTC)

I have suffered from headaches for 10 years everyday. I started taking more and more medicine just to be able to sleep and get through the day so it was close to a normal day. I lived on Tylenol PM and Motrin everyday all day long. About 5 days ago I stopped taking all the medicines cold turkey. Today is day 5 and I am suffering from rebound headaches. I started having them they day after I stopped taking them. I have not been able to work, I keep feeling like I am losing my mind. They hurt so bad. Does anyone have any advice that would help me get through this horrible pain and not fall back on the Tylenol and Motrin???24.210.138.49 (talk) 21:28, 31 October 2008 (UTC)

Rebound headaches in my opinion definitely do occur and I think the medical consensus is that they occur and quite frequently.-- Literature geek |  T@1k?  09:29, 2 February 2009 (UTC)

Unnecessary
Who cares if the doctor is Lisa Kudrow's father? I'm taking it out.24.170.2.84

I think it's an interesting tidbit and I put it back into "trivia."

Just an FYI: I have a colleague who worked with Dr. Kurdrow for many years. Neither Dr. Kudrow nor Lisa particularly care for this connection to be made. They feel that her "movie star" image does not do anything to help awareness of headache issues. --TeriRobert 06:24, 10 September 2006 (UTC)

Preventive medications
I appreciate the input from another user on the time necessary for preventive medications. I deleted "lifetime" and changed it to many years because migraine patients do not require prophylaxis for their entire lifetime. Thankfully, migraine is cyclical and women in particular rarely require prophylaxis after menopause. Importantly, medication overuse headache patients do not require lifetime prophylaxis... only a few months to break their headache cycle. Thanks. E4043 20:50, 9 September 2006 (UTC)

Preventive medications
Thanks. This is such a huge issue for so many patients.

May I please ask your source for "women in particular rarely require prophylaxis after menopause? I've not seen any data on this in the journals, and it's not what I see anecdotally from Migraineurs. If you know of any studies, I'd love to look them up and review them. Am always trying to stay up-to-date myself.

Thank you!

--TeriRobert 06:20, 10 September 2006 (UTC)

Sure here you go:

Cephalalgia. 1998 Feb;18 Suppl 21:30-3.

Headache. 2003 May;43(5):470-8.

E4043 05:02, 11 September 2006 (UTC)

Super! I'll look these up tomorrow. Thank you so much for taking time to give me the references. Are you a doctor?

--TeriRobert 06:12, 13 September 2006 (UTC)

Please Vote if you want the "Trivia" included or not
I actually think this is an interesting piece of information. I say we put this up for a vote before it gets deleted for good. Please vote yes or know if you think it's interesting trivia that the MD who discovered rebound headache is Dr. Lee Kudrow, who is the actress Lisa Kudrow's father. Thanks! I'm going to put it back in for now. E4043 00:46, 6 October 2006 (UTC)

And I've removed it again. Dr. Kudrow prefers to be known for his work, not for his daughter's "fame." If he was the first to explain rebound phenomena, then I think we could at least respect his wishes. For that matter, what is your source of this piece of "trivia?" Additioally, Dr. Kurdrow's son has now taken over the clinic his father started. He's doing a great deal of good work, but find that it's very disruptive to have somewhat celebrity status.

--TeriRobert 05:01, 8 October 2006 (UTC)

Teri, I would respectfully ask that you leave the trivia in until others have had a chance to vote. You have already made it clear how you feel about the topic. I can't help but find it peculiar how you take it upon yourself to protect Dr. Kudrow so vehemently... I think he's going to be ok. Please keep in mind that Wikipedia is a team effort and hard as it may be to accept, you are not always going to get your way. Thank you. E4043 04:47, 9 October 2006 (UTC)

Why do you find it peculiar that when I respect someone's work, I think we should honor their wishes about their privacy? I find it peculiar that you don't reply to my question about the source of your trivia, which you should be providing if you want it in the article, and that you are so disrespectful of the wishes of a man who helped thousands of patients during his career. There are several other headache articles where other people would be deleting this right now because you won't cite your source.

--TeriRobert 04:57, 9 October 2006 (UTC)

Teri, I'm not going to get in a fight with you about this. I have seen that you fight with other Wikipedians and throw tantrums when you don't get your way. It goes against the spirit of this website. We're all entitled to our opinions. I appreciate your not deleting again the trivia that i have put in. I will add the source for the trivia at your request. PMID: 7055014   Adv Neurol. 1982;33:335-41. E4043 05:20, 9 October 2006 (UTC)  PS -- I find it amusing that you feel that you alone speak for Dr. Kudrow. Where's your source to back up that statement?

I didn't know we were getting into a fight. If you consider asking for appropriate citation and accuracy a temper tantrum, I don't know what to say to you. You quite rightly bring up the spirit of this Web site; we should all strive to uphold it. I thought the spirit was for people to be able to contribute. Didn't realize that asking for a source was against the spirit, nor that thinking we should be respectful of what we say about people was an issue. My source of Dr. Kudrow preferring to be known for his work as opposed to his daughters accomplishments as an actress is a personal email from a partner in his medical practice. I do realize that personal email is not a verifiable source, and it's not something I would even have brought up had your "triva" been sourced in the first place. I'd like to point out to you that I was neither the first person nor the only person to remove it from the article. If you're an admistrator, please identify yourself as such. If not, feel free to report me to one. I don't see that you've contributed more to articles about headache disorders than I have. So, unless you're an adminstrator, if I understand the Wikipedia process and "pecking order" correctly, we're essentially "equals." If either of us has thrown a tantrum here (and I don't really think anyone has), consider that you're the one who has been obsessive about this piece of trivia that, until today, was not documented with it's source.

--TeriRobert 23:02, 10 October 2006 (UTC)

According to http://en.wikipedia.org/wiki/Wikipedia:Biographies_of_living_persons, no original research is allowed. So unless you cite a source, and explain why this isn't just using wikipedia as an information respository which according to [] it is not. it goes.

--Smkatz

Merge proposal
I think that this article should be merged into the rebound effect article. Rebound insomnia, rebound anxiety both redirect to rebound effect. The rebound effect article is now mostly about benzos and it would be benefitial I think to have rebound headache covered in that article and have it all together.-- Literature geek |  T@1k?  09:29, 2 February 2009 (UTC)


 * I am trying to organized headaches based on the ICHD classification. http://216.25.100.131/ihscommon/guidelines/pdfs/ihc_II_main_no_print.pdf  These headaches are officially known as Medication overuse headaches and there is more than enough literature to write a FA on it.  -- Doc James  (talk · contribs · email) 16:53, 3 February 2009 (UTC)

Ok fair enough. It is an important article I think. I think medication overuse headache is much more common than most people think and certainly plays a role in some cases of dependence on painkillers. One point on reading this article. In the treatment section it seems to recommend abruptly discontinuing the headache medication at least if it is over the counter variety. Surely this would lead to in a sizable number of patients to an acute worsening of the headaches and possible mild to moderate withdrawal effects if it is an opiate. Would it not make more sense to gradually reduce the dosage over a period of weeks or months to lessen rebound withdrawal related headache and other possible rebound withdrawal effects?-- Literature geek |  T@1k?  17:43, 3 February 2009 (UTC)

I added a couple of links, I hope they are ok.-- Literature geek |  T@1k?  07:14, 4 February 2009 (UTC)


 * Complicated issue. These headaches are relatively common.  Narcotics are known to make headaches more frequent even if used occasionally.  All these headache articles need substantial work.  Will try to address some of the problems unless someone gets to it first.-- Doc James  (talk · contribs · email) 17:47, 5 February 2009 (UTC)

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