• Kasja Rabe, Lutz Pageler, Charly Gaul, Christian Lampl, Torsten Kraya, Stefanie Foerderreuther, Hans-Christoph Diener, and Zaza Katsarava.
• Department of Neurology and Headache Center, University Duisburg- Essen, Germany. kasja.rabe@uk-essen.de
• Cephalalgia. 2013 Feb 1;33(3):202-7.

PurposeTo investigate the efficacy of prednisone for treatment of withdrawal headache in patients with medication overuse headache (MOH).Patients And MethodsIn this prospective double-blind, placebo-controlled, parallel designed multicentre trial, 96 consecutive patients with MOH were randomized to withdrawal treatment with either 100 mg prednisone or placebo over 5 days. Patients were enrolled if they met the International Headache Society criteria for MOH and were diagnosed with migraine or episodic tension-type headache as primary headache. Exclusion criteria comprised significant neurological or psychiatric disorders. Withdrawal symptoms, including headache severity and intake of rescue medication, were documented for 14 days after randomization.ResultsPatients treated with prednisone did not experience fewer hours of moderate or severe headache than patients receiving placebo. However, patients requested less rescue medication within the first 5 days.ConclusionsDuring withdrawal in MOH, prednisone reduces rescue medication without decreasing the severity and duration of withdrawal headache.

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