One of the biggest stumbling blocks for migraineurs, particularly those who have had migraines for years, is medication overuse headaches (MOH).
MOH is the official classification for the common term “rebound headaches”. These are headaches (and even migraines) which occur because of the medication and drugs we’re taking. Typically it occurs when taking medication too often which causes a physical dependence on the drug. When the medication is stopped withdrawal symptoms are experienced and result in a headache or migraine.
MOH often goes unnoticed. Many doctors fail to ask about the frequency and type of medication you’re taking and if there not looking for it, it’s easily missed.
If you experience daily migraine attacks or headaches, there is a 30% to 50% chance you overuse acute medications.
Up to 80% of those who visit migraine headache specialty clinics either overuse acute medication or already have MOH.
MOH is a complication of migraine. It is a secondary condition as a result of the overuse of treatment for the primary migraine or headache. Even if an individual has migraines, MOH becomes the prioritised condition to treat before any progress can be made on the underlying migraine condition. This is the case even if migraines caused MOH in the first place.
MOH is extremely important to address first and foremost. MOH can block or reduce the effectiveness of other treatments. It can be extremely difficult to reduce your migraine frequency whilst you have MOH.
For most migraineurs, they don’t even realise they have MOH. For others, they might feel trapped and concerned about withdrawal symptoms. As you’ll discover from this guide, MOH is very treatable with strong success rates. By addressing MOH, you can get back to improving your migraine condition.
Carl from MigrainePal
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Headaches are the most common pain issue brought to physicians and a major reason cited for missed work and school days. Although most headaches are benign, some headaches are disabling enough to compromise a person’s ability to work, socialize and exercise. The financial burden of headaches on the afflicted is currently believed to be greater than that of diabetes, asthma or high blood pressure.
Migraines are also now viewed as a progressive disease which, like heart disease or high blood pressure, may worsen and become more difficult to treat over time. Hossein Ansari, MD, a board-certified neurologist who specializes in diagnosing and treating headaches and facial pain, talks about how to differentiate a migraine from an ordinary headache and potential treatments.
Question: What is a migraine?
Answer: A migraine is a complex neurologic disease with a genetic basis and is not synonymous with a severe headache. Migraine suffers may experience symptoms we call aura without ever having headaches. Aura symptoms can be visual (e.g., seeing dots and lines) or sensory (e.g., numbness on the cheeks, arms or legs) or speech-related.
Q: What are some symptoms suggesting that I should seek medical help for my headaches?
A: Individuals should seek immediate referral to a neurologist, preferably a headache specialist, if they experience any of the following: a stiff neck or fever with a headache or a headache that gets worse when lying down; constant numbness, dizziness, weakness or difficulty with speech; confusion, drowsiness or loss of consciousness with headaches; headaches for the first time after age 50 or “the worst headache of your life.” Those who develop headaches while on an immunosuppressant, such as chemotherapy or steroids, should also seek immediate help from a neurologist.
Q: What is known about the relationship between foods and fasting in triggering migraines? What about alcoholic beverages?
A: Artificial sweeteners, nitrates (often found in processed meats) and MSG can induce migraines. Most migraine triggers assumed to be food-related, though, are actually part of the migraine itself. By this I mean that before a headache begins, a person may experience food cravings or aversions. Fasting and alcohol, particularly red wine, can also trigger migraines.
Q: What can I do to prevent migraines?
A: We recommend regular, light exercise at least three days a week. Yoga, tai-chi and other mind-body practices are particularly beneficial. Multiple studies show that migraines often become chronic among overweight individuals. For this reason, attaining or maintaining a healthy, normal weight is critical. Drinking plenty of fluids, avoiding stress and getting adequate sleep are also important.
Q: How do you differentiate a sinus headache from a migraine?
A: Headache specialists consider the term sinus headache a misnomer. Most persons who think they have sinus headaches actually suffer from migraines.
Q: What about hormone fluctuations and migraines?
A: Hormonal fluctuations associated with the menstrual cycle can bring on migraines. Hormone therapies that regulate estrogen levels can avert attacks. Women who have migraines with aura should avoid certain birth control pills to prevent an increased risk of stroke.
Q: What are the most promising investigational treatments in the pipeline?
A: The most promising interventional treatment is a surgical procedure known as a migraine trigger point deactivation surgery. There is also a new drug on the horizon – a calcitonin gene-related peptide (CGRP), long postulated to play a key role in the pathophysiology of migraines – that has shown promise in preclinical and clinical trials.
Source: UC San Deigo Health Headache Help: Q&A with Hossein Ansari, MD
Here I am again. 3:30 am. Typing about my feelings. Wanting so badly to be asleep. Deep, restorative sleep. No dreams sleep. Reassuring sleep. Rejuvenating sleep. But sleep is becoming a dream in itself. Short, light sleep is what I get. If I go too deep into REM, the nightmares come. I don’t remember them as a whole. Just bits and pieces. They’re dark, scary, fraught with anxiety and panic. Clawing at the light. Begging to wake up. And I do. And it all starts again. A cycle of pain, fear, sleep, wake, dream, flashes of memory, dark, light. Too afraid to fall asleep, too exhausted not to. Endless circles of day and night blending together. Dawn is my time to think, type, try to put down into words what is happening to me. Not to scare others, not to scare myself. But to seek out those who feel as I do. For reassurance. For comfort. For ideas. Suggestions. To know I’m not alone. Because at 3:00 am, I feel alone. #AlwaysKeepFighting