Response to bridge phase treatment in Medication Overuse Headache

Objective: Withdrawal of the overused drugs in medication overuse headache (MOH) can contribute to severe rebound headache and many other symptoms. In this regard, some centers perform bridge therapy during the days of withdrawal to manage the rebound headache and withdrawal symptoms resulting from the discontinuation of the offending drug. To investigate the response to treatment during bridge therapy and the association between different risk factors and response to therapy in patients with MOH. Method A total of 178 MOH patients with a mean age of 43.29 years and at least one failed outpatient course of treatment was evaluated in the current retrospective cross-sectional study. We investigate the effectiveness of different medications administered during the bridge phase as well as the association between response to treatment and several risk factors. Response to treatment was defined as an improvement of more than 50% in attack duration or intensity 72 hours after receiving treatment. Results In our MOH series, all patients who received methylprednisolone and about 70% of those who were treated with celecoxib during bridge therapy, had a response rate of more than 50%. Additionally, MOH duration was significantly shorter in patients with a high response to treatment compared to a low response group. Conclusion Our finding suggests that methylprednisolone and celecoxib with high response rates could be good choices as bridge phase therapy in MOH patients. The inverse relationship between the duration of MOH and response to treatment also emphasizes the importance of early diagnosis and treatment of MOH.