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Behavioral Approach in the Treatment of Chronic
Daily Headache with Drug Overuse:
a 3-year follow-up study
L. Grazzi, et al.
Posted: March 2005  
Cephalalgia Vol. 20, Number 4

Introduction:   Patients with chronic daily headache (CDH) are prone to use many drugs to abort attacks. Medication overuse must be interrupted before introducing a preventive treatment.

Methods:   Sixty-one patients suffering from CDH with drug overuse entered the study. They underwent inpatient drug withdrawal. Then they were divided into two groups: group A patients underwent only preventive pharmacological treatment; group B patients were treated by pharmacological treatment associated to behavioral therapy by EMG-biofeedback-assisted relaxation (eight sessions). Patients were followed for a period of 3 years. Clinical improvement was evaluated by comparing data from the headache diary, the month before withdrawal vs. the month before the last follow up visit.

Results:  At the 3-year follow up, a reduction in number of days with headache per month was observed in both groups. Post-treatment data showed a significantly higher reduction in group B vs. group A for number of days with headache per month, as well as for the number of symptomatic drugs per month.

Conclusions:   Our data suggest that, when biofeedback treatment is associated to pharmacological preventive therapy in CDH patients with drug overuse, patients show better clinical results (reduced headache frequency and drug consumption) considering a long follow up period after drug withdrawal.