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CHRONIC DAILY HEADACHE, MEDICATION OVERUSE HEADACHE

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Sheftell FD, Brunton SA, Coon TL, Hutchinson SL, Kaniecki RG. Chronic daily headache: Understanding and treating a common malady. Fam Practice Recertification. 2004;26:25-36.

Chronic daily headache affects 4% to 5% of the general population, half of whom have transformed or chronic migraine and half of whom have chronic tension-type headache. The overuse of prescription and nonprescription medications, particularly analgesics, is a prime contributor. Treatment may include stopping the offending medications, bridge therapy for withdrawal symptoms, and nonpharmacologic techniques such as lifestyle changes and behavioral therapy.

Comments: This article represents the fruits of a multidisciplinary (Psychiatry: Dr. Sheftell; Family Practice: Drs. Brunton, Coon, and Hutchinson; and Neurology: Dr. Kaniecki) roundtable with the task of describing the basics on chronic daily headache to family practitioners. The section on how to withdraw patients in rebound is particularly helpful, and I have been recommending the article when asked for practical approaches for these patients.—Stewart J. Tepper
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Document Type: Research Article

Publication date: September 1, 2004

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