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Medication-overuse headache (MOH)
Chronic and excessive use of medication to treat headache is the cause of MOH, another of the chronic daily headache syndromes. A typical history of MOH begins with episodic headache – migraine or TTH. The condition is treated with an analgesic or other medication. Over time, headache episodes become more frequent, as does medication intake, until both are daily.
A common and probably key factor in the development of MOH is a switch to pre-emptive use of medication. MOH is oppressive, persistent and often at its worst on awakening. What constitutes overuse is not clear. Suggested limits are the regular intake of simple analgesics on 15 or more days per month or of codeine- or barbiturate-containing combination analgesics, ergotamine or triptans on more than 10 days a month. In prevalence, MOH far outweighs all other secondary headaches. It affects up to 5% of some populations, women more than men.
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