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Chronic daily headache with medication overuse: predictors of outcome 1 year after withdrawal therapy

Authors

  • M. G. Bøe,

    1. Department of Neurology, Sørlandet Hospital, Kristiansand, Norway
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  • R. Salvesen,

    1. Department of Neurology, Nordland Hospital, Bodø, Norway
    2. Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway
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  • Å. Mygland

    1. Department of Neurology, Sørlandet Hospital, Kristiansand, Norway
    2. Hospital of Rehabilitation, Rikshospitalet University Hospital, Kristiansand, Norway
    3. Institute of Clinical Medicine, University of Bergen, Bergen, Norway
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Magne G. Bøe, Department of Neurology, Sørlandet Hospital, Kristiansand, Norway (tel.: +47 38 07 39 10; fax: + 47 38 07 39 11; e-mail: magne.geir.boe@sshf.no).

Abstract

Background and purpose:  We examined prospectively the results of withdrawal therapy in 80 patients with probable medication overuse headache. The aim was to identify baseline patient characteristics that might predict outcome after 1 year (end of study).

Methods:  We classified patients according to results of withdrawal therapy measured as the improvement of headache days (HD) from baseline to end of study.

Results:  Thirty-six per cent (29/80) had at least 50% improvement. Sixty-four per cent (51/80) had <50% improvement, and among these, 30% (24/80) had <10% improvement. The following baseline characteristics were associated with poor outcome of withdrawal therapy: use of codeine-containing drugs, low self-reported sleep quality, and high self-reported bodily pain as measured by the quality of life tool SF-36.

Conclusion:  Before suggesting withdrawal therapy, one should probably pay more close attention to sleep problems.

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