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)
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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)
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Overview

Title

Management of Headache

Authoring Organization

Veterans Health Administration / Department of Defense