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Medication Overuse Headache: Rates and
Predictors for Relapse in a 4-Year Prospective Study
Z Katsarava, M Muessig, A Dzagnidze, et al.
Posted: February 2005  
Cephalalgia 2005;25:12-15

We present a prospective 4-year follow-up study of 96 patients with medication overuse headache following withdrawal. Complete datasets were available from 85 patients 6 months after withdrawal, from 79 patients 1 year after withdrawal, and from 75 patients 4 years after withdrawal. Twenty-six patients relapsed within the first 6 months after withdrawal. The number of relapses increased to 32 one year and to 34 four years after withdrawal. The 4-year relapse rate was lower in migraine than in tension-type headache and combination of migraine and tension-type headache, and also lower in patients overusing triptans than analgesics. The study suggests that the majority of relapses occur within the first year after withdrawal and that the long-term success of withdrawal depends on the type of primary headache and the type of overused medication.