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Management of Headache
Publication Date: September 30, 2023
Last Updated: October 12, 2023
Medication Overuse Headache Screening and Other Considerations
We suggest providers assess for and consider the following high-risk factors for medication overuse headache in patients with headache (in order of relative impact):
Headache frequency (greater than or equal to 7 days per month)
Migraine diagnosis
Medication use: frequent use of anxiolytics, analgesics (for any condition, including use of opioids or non-opioid analgesics for acute treatment of migraine), or sedative hypnotics
History of anxiety or depression, especially in combination with musculoskeletal complaints or gastrointestinal complaints
Physical inactivity
Sick leave of greater than 2 weeks in the last year
Self-reported whiplash
Smoking (tobacco use)
(Weak for)
315659
Pharmacotherapy
Headache - Preventive
There is insufficient evidence to recommend for or against coenzyme Q10, feverfew, melatonin, omega-3, vitamin B2, or vitamin B6 for the prevention of headache. (Neither for or against)
315659
There is insufficient evidence to recommend for or against fluoxetine or venlafaxine for the prevention of headache. (Neither for or against)
315659
Overview
Title
Management of Headache
Authoring Organization
Veterans Health Administration / Department of Defense