Is Detoxification Needed in Medication-overuse Headache?

Medication-overuse headache (MOH) is a disabling condition, yet treatable. According to European guidelines and based on evidence, multidisciplinary detoxification is the first choice of treatment for MOH. However, consensus about the details in such detoxification programs is lacking. Contrary, other headache specialists believe more in treating chronic headache with medication overuse with single-therapy of prophylaxis and no withdrawal of acute medication, based on randomized controlled double-blinded placebo trial with prophylaxes. Only a single RCT has compared single-therapy with prophylaxis to detoxification. However there was no significant difference. AIM: 1. To compare three different treatment protocols in order to improve the therapy of MOH. 2. To test several baseline variables for being potential predictors for good treatment outcome. 3. To examine the role of epigenetics in MOH.