MOH is a secondary headache disorder resulting from excessive use of acute medications for a prolonged period of time. Behaviours of substance dependence are common among patients with MOH [3]. “More than two-thirds of patients with MOH can fulfil the criteria for substance dependence,” Dr Yen-Feng Wang (Taipei Veterans General Hospital, Taiwan) added. “Besides, substance use disorders and chronic pain disorders, including migraine, are associated with increased suicidal risks [4].” However, the potential risks of suicide in MOH are unknown.
In this prospective, cross-sectional study, 603 patients with chronic migraine (485 women; mean age 42) were recruited, including 320 patients with MOH (257 women) [1]. Patients with MOH were significantly younger at migraine onset (20.7 vs 23.0 years; P=0.004). Despite comparable headache frequencies in patients with or without MOH (23.3 vs 22.4; P=0.098), patients with MOH had higher monthly analgesic use (19.4 vs 4.5 days per month; P<0.001). In contrast, the presence of disease-related disability symptoms such as anxiety, depression, and sleep quality was comparable between patients with or without MOH.
Among patients with chronic migraine, patients with MOH were more likely to have suicidal ideation and prior suicide attempt (see Figure). “However, it is important to exclude the possibility of potential confounders,” Dr Wang added. After controlling for demographics, headache profile, disabilities, symptoms of anxiety and depression, and sleep quality, the OR for suicidal ideation was 1.75 (P=0.004) and the OR for prior suicide attempt was 1.88 (P=0.024).
Figure: Proportion of individuals with suicidal ideation and prior suicide attempt in patients with or without MOH [1]
- Wang YF, et al. Association between suicidal risks and medication-overuse headache in chronic migraine: a cross-sectional study. AL015, IHC 2021, 8–12 September.
- Wang YF, et al. J Headache Pain. 2021;22(1):36.
- Radat F, et al. Headache. 2008;48(7):1026–36.
- Yuodelis-Flores C, Ries RK. Am J Addict. 2015;24(2):98–104.
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Table of Contents: IHC 2021
Featured articles
Letter from the Editor
COVID-19
Telemedicine beneficial for headache care during the pandemic
Comparison of headaches after SARS-CoV-2 vaccination
Grey matter cortical changes in patients with persistent headache after COVID-19
Increased risk of cerebral venous thrombosis in COVID-19
Patient Perception and Symptoms
Predictors of health-related quality of life in cluster headache
Dry eye disease is more prevalent in migraine
Voice change and throat swelling are cranial autonomic symptoms in primary headache
Association between physical inactivity and headache disorders
Increased suicidal attempts and risks of ideation in medication-overuse headache
Cardioembolic Comorbidities
AI-enabled ECG algorithm predicts atrial fibrillation risk in migraine
Migraine may not be a risk factor for stroke
Imaging
Functional brainstem somatotopy of the trigeminal nerve during nociception
Morphological changes in cluster headache between attacks
Interictal pontine metabolism in migraine patients without aura
Genome-Wide Association Studies
Largest genome-wide association study of migraine to date
Robust evidence that cluster headache has a genetic basis
Pharmacological Treatment
Insights in drug-drug interactions facilitate rational polypharmacy
Rimegepant confers long-term improvements in MMDs
First real-world effectiveness data of erenumab is promising
Galcanezumab effective in patients with episodic or chronic cluster headache
Central effects and affected somatosensory processing with galcanezumab in migraine
Long-term safety and tolerability of atogepant in migraine
Non-Pharmacological Treatment
Occipital nerve stimulation effective and safe in chronic cluster headache
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