Drug-induced headache (synonyms: Drug-induced headache; Medication-overuse headache; Drug-induced headache; Medication-induced headache (MIK);ICD-10-GM G44.4: Drug-induced headache, not elsewhere classified) refers to medication-overuse headache (MOH).
Medication overuse refers to the use of ergotamines, opioids, analgesics (pain relievers)-mixed medications, triptans, or combinations of acute medications on ≥ 10 days/month. For analgesics (e.g., acetylsalicylic acid, ibuprofen, acetaminophen), medication overuse is present if taken ≥ 15 days/month.
Notes on nomenclature:
- Medication overuse-frequent medication use does not worsen the primary headache.
- Medication overuse headache – when medication is taken frequently for acute headache therapy, chronicity occurs (secondary headache)
Diagnostic criteria for “medication overuse headache” see below Classification: IHS criteria (International Headache Society).
Basically, any medication used for headache can also trigger headache.
Drug-induced headache often affects people with migraine.
The prevalence (disease frequency) is estimated at about 0.2-2% (in Germany).
Course and prognosis: With regard to painkillers and migraine medications, prophylaxis is started and, in addition, attempts are made to reduce acute medication considerably or to omit it over a period of time. Thus, in clinical practice, a significant improvement in symptoms is achieved in 70 to 80% of these patients.The data on relapses vary widely, averaging around 32%. Structured eduction (counseling and training) and consistent follow-up can certainly further reduce the risk of recurrence of medication overuse.
