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Clinical Features of Withdrawal Headache Following
Overuse of Triptans and Other Headache Drugs
Katsarava Z, Fritsche G, et al.
Posted October 2002
Neurology 2001; 57:1694-1698
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Background: Complete withdrawal from headache medication is the treatment of choice for medication-overuse headache. Discontinuation of the overused headache medication, however, results in the development of withdrawal headache, often associated with nausea, vomiting, and sleep disturbances.
Results: The duration of withdrawal headache was shorter in patients overusing triptans than in patients overusing ergots or analgesics. The mean headache intensity on the first day of withdrawal did not differ between the groups. By day 14, however, it was lower in patients overusing triptans than in patients overusing ergots or analgesics. Rescue medication was requested less by patients undergoing triptan withdrawal than by patients undergoing ergot withdrawal or analgesic withdrawal. Similar to findings in the entire patient population, withdrawal headache was shorter and less severe in migraineurs overusing triptans than in those overusing ergots or analgesics. Because only patients with migraine, but no patient with tension-type headache, overused triptans, withdrawal headache was shorter in the group of patients with migraine alone.
Conclusion: The duration and severity of withdrawal clearly depend on the type of overused headache drug only.
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