All acute medications used for migraine attacks, when used too frequently, increase the risk of medication overuse headache with progression to a chronic daily headache syndrome. Use of opioids, triptans, ergotamines, or combination analgesics of any kind on 10 days a month or more, and use of NSAIDs or acetaminophen on 15 days a month or more places patients at risk for medication overuse headache. Patients with migraine should be educated with regard to these risks.

Conditions: migraine attacks, headache

Diagnostic Tests: headache diary

Treatments: over-the-counter (OTC) analgesics, pain killers, opioids, triptans, ergotamines, combination analgesics

Sources

• Becker WJ, Purdy RA. Medication overuse headache in Canada. Cephalalgia. 2008 Nov;28(11):1218-20. (PubMed)
• Cheung V, Amoozegar F, Dilli E. Medication overuse headache. Curr Neurol Neurosci Rep. 2015 Jan;15(1):509. (PubMed)
• Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808. (PubMed)