Medication-overuse headache (MOH) is a secondary headache disorder caused by the regular overuse of acute headache medication. According to the International Classification of Headache Disorders (ICHD-3), MOH is diagnosed in individuals with a pre-existing headache disorder when headache days reach 15 or more days per month and medication overuse persists for 3 or more months. MOH is entirely preventable but lacks clinical awareness. A pillar in the treatment of MOH is withdrawing from the overused medication. Sometimes withdrawal is combined with prophylactic treatment. The pathophysiological mechanisms are not fully elucidated. The following mechanisms are suspected to be involved: central and peripheral sensitization of the trigeminovascular system, impaired descending pain modulation, and cortical hyperexcitability. This narrative review provides a current overview of the epidemiology, diagnosis, pathophysiology and treatment of MOH.
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Melchior et al. (2026) studied this question.
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