The study, recently published in European Journal of Neurology, found that nearly 50% of chronic headache sufferers also suffer from Medication Overuse Headaches, and that these patients had significantly higher headache disability and anxiety scores than the general population.

The researchers employed a double-blind pragmatic cluster randomized controlled trial, carried amongst 50 general practitioners in Norway. A brief intervention (BI) for Medication Overuse Headaches in primary care was examined. The brief intervention was com- pared to business as usual (BAU) and population controls, and patients were followed up after 3 months.

The primary outcomes of the study were measured by the headache and medication days per month after the 3 months. Headache disability and the Hospital Anxiety and Depression Scale (HADS) were also measured as secondary outcomes.

According to Dr. Elliot Shevel, South Africa’s migraine surgery pioneer and the medical director of The Headache Clinic, the results clearly show that the brief intervention was significantly better than business as usual after 3 months regarding primary outcomes. The Medication Overuse Headache patients had significantly higher headache disability and anxiety scores than the population controls,” he says. “This shows an association be- tween these variables.” The main conclusion of the study was that patients with Medication Overuse Headaches are a highly disabled group where anxiety and depression are important comorbidities.

Dr Shevel explains that the disability, anxiety, and depression are very frequently a con- sequence of the underlying pain, in other words, they are secondary to the pain. The best way therefore to treat the disability, anxiety and depression, according to Dr. Shevel, is to identify and treat the underlying pain. Once the source of the chronic pain is identified and treated, the secondary symptoms diminish or disappear spontaneously, and do not need further treatment. This is the approach used at The Headache Clinic, and has proven an incredibly successful method of treatment.

“Dr Shevel says that “the best method of treating Medication Overuse Headaches is to treat the original headache. When the original source of the pain is successfully treated, the Medication Overuse Headache spontaneously subsides. The reason for this is that the pain of the Medication Overuse Headaches comes from the same source as the original headache – when the pain source is treated, both the original headache and the Medication Overuse Headaches are treated simultaneously”.