Treatment of Medication-Overuse Headaches
Education is the most important measure. Short-acting drugs such as butalbital and most opioids are of higher risk for habituation than longer-acting drugs such as ibuprofen or naproxen. The first step is to stop the medication. Generally, this can be done abruptly. Pick a long weekend so withdrawal headache, which is common though temporary, is better tolerated. Start a preventative if the patient is not already on one. If the drug is butalbital or opioids, use a triptan during the withdrawal. There are several choices for rescue medications. I favor indomethacin in combination with metoclopramide and a steroid dose pack if that fails.
Dr. Florin is committed to treating all patients compassionately with state-of-the-art techniques while maintaining their dignity and independence. He views each patient encounter as a collaboration. Dr Florin has over 35 years of experience. He is Adjunct Clinical Professor at Keck School of Medicine (USC) and is the founder and medical director of the Fullerton Neurology and Headache Center. He has been recognized by the Orange County Medical Association as a Physician of Excellence in Neurology. US News and World Report ranks him in the top 10% of neurologists nationwide.
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