HEADACHE: Edited by Messoud AshinaPrevention and management of medication overuse headacheRussell, Michael Bjørna,b; Lundqvist, Christofera,b,c,dAuthor Information aHead and Neck Research Group, Research Centre, Akershus University Hospital, 1478 Lørenskog bInstitute of Clinical Medicine, University of Oslo, 1474 Nordbyhagen cHØHK, Research Centre dDepartment of Neurology, Akershus University Hospital, 1478 Lørenskog, Norway Correspondence to Michael Bjørn Russell, professor, MD, PhD, DrMedSci, Head and Neck Research Group, Research Centre, Akershus University Hospital, 1478 Lørenskog, Norway. Tel: +47 67 96 83 81; e-mail: firstname.lastname@example.org Current Opinion in Neurology: June 2012 - Volume 25 - Issue 3 - p 290-295 doi: 10.1097/WCO.0b013e328352c431 Buy Metrics Abstract Purpose of review This review provides an update on our knowledge regarding prevention and management of medication overuse headache (MOH). Recent findings The prevalence of MOH is 1–2% in the general population worldwide, and because of the tremendous socio-economic cost, it is likely to be the most costly neurological disorder known. MOH has similarities with traditional drug addiction. Use of a brochure on medication overuse can prevent MOH. The Severity of Dependence Scale (SDS) score is a significant predictor of medication overuse among headache patients. Withdrawal of medication is essential in the management of MOH, and simultaneous initiation of prophylactic medication may alleviate this process. Short advice on medication overuse by a physician reduced mean medication days from 22 to 6 days; 76% no longer had medication overuse and 42% no longer had chronic headache. Summary A brochure and/or the SDS should be used to prevent MOH. Withdrawal is the cornerstone of MOH management. Short advice on MOH is the current most cost effective management method, a method that can be applied anywhere including third world countries. © 2012 Lippincott Williams & Wilkins, Inc.