Prednisone eases withdrawal headache after medication overuse

Last Updated: 2008-02-29 16:42:37 -0400 (Reuters Health)

NEW YORK (Reuters Health) – Prednisone relieves symptoms during withdrawal therapy for medication overuse headache (MOH), according to a report in the February issue of Cephalalgia.

Discontinuation of overused anti-headache medication usually leads to severe withdrawal headache, with such additional symptoms as nausea, vomiting, hypotension, and tachycardia, the authors explain.

Dr. Lutz Pageler from Cologne City Hospitals, Cologne, Germany and colleagues conducted a randomized trial to compare the efficacy of 100 mg prednisone vs placebo given daily for 5 days for the treatment of symptoms following withdrawal of overused anti-headache drugs in 20 patients.

Patients treated with prednisone experienced significantly fewer hours with severe or moderate headache within the first 72 and 120 hours than did patients who received the placebo, the authors report.

Patients in the prednisone group requested rescue medication about half as frequently as patients in the placebo group, the report indicates, but this difference did not reach statistical significance.

"Our results suggest that prednisone could be effective in treatment of medication withdrawal headache and that the drug may facilitate withdrawal therapy," the authors write.

"The possible action of steroids in the treatment of medication overuse headache and other headaches such as cluster headache or status migrainosus still needs to be determined," the investigators conclude. They add that as a consequence of this trial, a multicenter phase III study is already underway in Europe.

Cephalalgia 2008;28:152-156.