Lancet neurology
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With the recent launch of the joint Global Campaign to reduce the burden of headache by the World Headache Alliance (WHA), the International Headache Society (IHS), the European Headache Federation (EHF), and WHO, a welcome focus on the management of migraine is expected. Migraine management is influenced by numerous factors that are regionally different around the world. ⋯ The efforts needed to remedy the situation are also discussed. Hopefully this article will serve to emphasise again the well-known maxim that treatment of migraine is much more than just a prescription!
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Medication overuse and subsequent medication-overuse headache (MOH) is a growing problem worldwide. Epidemiological data suggest that up to 4% of the population overuse analgesics and other drugs for the treatment of pain conditions such as migraine and that about 1% of the general population in Europe, North America, and Asia have MOH. ⋯ Along with these findings the new international classification of headache disorders has now incorporated additional criteria and new headache entities that will facilitate the diagnosis of MOH. Withdrawal therapy is the only treatment for this disorder and clear restriction of monthly doses is the central requirement for successful prevention.