Chronic daily headache with medication overuse: predictors of outcome 1 year after withdrawal therapy

We examined prospectively the results of withdrawal therapy in 80 patients with probable medication overuse headache. The aim was to identify baseline patient characteristics that might predict outcome after 1 year (end of study). We classified patients according to results of withdrawal therapy measured as the improvement of headache days (HD) from baseline to end of study. Thirty-six per cent (29/80) had at least 50% improvement. Sixty-four per cent (51/80) had < 50% improvement, and among these, 30% (24/80) had < 10% improvement. The following baseline characteristics were associated with poor outcome of withdrawal therapy: use of codeine-containing drugs, low self-reported sleep quality, and high self-reported bodily pain as measured by the quality of life tool SF-36. Before suggesting withdrawal therapy, one should probably pay more close attention to sleep problems.