Ep 220 – Medication overuse headache

Medication overuse headache (MOH) is a common but frequently overlooked cause of chronic daily headache, particularly in people with migraine. In this episode, Dr Roger Henderson explores how regular use of acute headache medications can paradoxically drive increasing headache frequency, creating a cycle of persistent pain and escalating medication use. Clinical features that should raise suspicion and the diagnostic criteria are discussed, along with why asking patients how many days each month they take headache medication is often the most important question in the consultation. This episode also examines the proposed mechanisms underlying MOH, practical approaches to diagnosis and evidence-based management, including medication withdrawal, preventive therapy and patient education. By recognising MOH early, GPs can often achieve substantial improvements in headache control and quality of life without simply prescribing another acute treatment.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/neurology/ep-220-medication-overuse-headache

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